Does Self-Reported Drug Allergy Influence Clinically Significant Outcome Improvement and Graft Failure Rates After Meniscal Allograft Transplantation of the Knee?

Abstract

Background: Emerging research suggests that immune responses may influence results after various orthopaedic operations. This study aimed to determine if similar relationships exist in meniscal allograft transplantation (MAT).

Purpose: To compare clinical outcomes and failure rates for patients who underwent MAT based on presence or absence of self-reported drug allergies.

Study design: Cohort study; Level of evidence, 3.

Methods: A retrospective review of patients who underwent MAT from January 2004 to December 2021 at a single academic medical institution was conducted with minimum follow-up of 2 years. Age, sex, body mass index, and presence of concomitant procedures were collected. The presence or absence of patient-reported allergies was recorded from the electronic medical record. Graft failure was defined as removal or revision of primary MAT, subsequent cartilage procedure, or progression to arthroplasty. The Lysholm score, International Knee Documentation Committee (IKDC) score, and all Knee injury and Osteoarthritis Outcome Score (KOOS) were compared for each patient from preoperative to 2-year time points. The minimal clinically important difference was determined using distribution-based method.

Results: A total of 107 patients who underwent MAT with minimum follow-up of 2 years were included in the study. Of the total, 22 (20.6%) had self-reported ≥1 medication allergy and 85 (79.4%) did not report any medication allergies. There were no significant differences between the no-allergy and allergy cohorts in other demographic variables. There was no significant difference in failure rate between the no-allergy and allergy cohorts (18.1% vs 8.2%; P = .17). There were no statistically significant differences in Lysholm, IKDC, or KOOS subscales preoperatively or at 2 years postoperatively. Self-reported drug allergies did not serve as a significant risk factor for failing to achieve minimal clinically important difference across any outcomes in the patient population.

Conclusion: The presence of self-reported drug allergies does not appear to adversely affect clinically significant outcome improvement or graft survival rates in patients undergoing MAT. These findings suggest that self-reported allergies should not be considered a limiting factor for MAT and that surgeons can continue to focus on other patient-specific factors that may be more predictive of postoperative outcomes.