Meniscal Allograft Transplantation Fixation Technique Type Does Not Meaningfully Impact Patient-Reported Outcomes: A Systematic Review of Clinical Outcomes.

Abstract

Purpose: To systematically review the current literature and investigate whether there are any significant differences in outcome between fixation techniques for medial or lateral meniscal allograft transplantation (MAT).

Methods: A systematic search was conducted of PubMed, Scopus, and Embase. Reported data on demographics, location of MAT, graft fixation techniques, meniscal extrusion, graft failure, and postoperative patient-reported outcomes (PROs) were extracted and tabulated. The results were analyzed, and subgroup analysis was performed to isolate the results of medial and lateral MAT.

Results: Twenty-seven articles met inclusion criteria without meeting exclusion criteria. In total, there were 1622 individual cases of MAT with 1125 lateral MATs, 80 medial MATs, and 417 MATs where compartment was not specified. MAT was associated with improved PROs regardless of fixation technique. Few studies directly compare different fixation techniques for MAT, but, based on the available data, there is no clear advantage of any fixation technique for medial or lateral MAT with regard to PROs or graft failure. However, meniscal extrusion appears to be greater for soft-tissue only fixation.

Conclusions: With regard to PROs and failure rates, there is no clear advantage of any fixation technique for medial or lateral MAT; however, high-quality comparative studies are limited. Therefore, surgeons can weigh other options such as concomitant procedures and technical familiarity when determining the fixation method for medial or lateral MAT.

Level of evidence: Level III, systematic review of Level II and III studies.