Acta Ortopédica Mexicana

Chana-Rodríguez F, Villanueva-Martínez M, Rojo-Manaute JM, Pérez-Mañanes R, Mediavilla-Santos L, Vaquero-Martín J
Total knee arthroplasty in a patient with meniscal transplantation
Acta Ortop Mex 2013; 27 (6)

Language: Español
References: 16
Page: 402-404
PDF: 188.79 Kb.

[Fulltext - PDF]

ABSTRACT

Background: The natural history of a knee subjected to total meniscectomy leads to poor outcomes, so we should be careful with these lesions. Meniscal transplantation may be a proper treatment for these patients as it involves a good medium-term survival. Material and method: We report the case of a 52 year-old male who underwent meniscal transplantation and developed left gonarthrosis. The surgical approach consisted of medial longitudinal arthrotomy and implantation of a posterior stabilized prosthesis after releasing the soft tissues, which were very retracted. Results: At the one year follow-up the operated knee had an articular range of 0-110o, with no gap and no pain; no external support was required for walking. Conclusions: Despite the fact that most case series report good short- and medium-term results, some patients do not have good results and need a total knee prosthesis.


Key words: Arthroplasty, knee, graft, meniscus.


REFERENCES

  1. 1.Baratz ME, Fu FH, Mengato R: Meniscal tears: the effect of meniscectomy and of repair on intraarticular contact areas and stress in the human knee. A preliminary report. Am J Sports Med. 1986; 14: 270-5.

  2. 2.Seedhorn BB, Hargreaves D: Transmission of the load in the knee joint with special reference to the role of the menisci. Part II: Experimental results, discussion, and conclusions. Eng Med. 1979; 8: 220-8.

  3. 3.Voloshin AS, Wosk J: Shock absorption of meniscectomized and painful knees: a comparative in vivo study. J Biomed Eng. 1983; 5: 157-61.

  4. 4.Lawrence JS, Bremner JM, Bier F: Osteoarthrosis. Prevalence in the population and relationship between symptoms and x-ray changes. Ann Rheum Dis. 1966; 25: 1-24.

  5. 5.Insall JN, Dorr LD, Scott WN: Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res. 1989; 248(11); 13-4.

  6. 6.Radin EL, de Lamotte F, Maquet P: Role of the menisci in the distribution of stress in the knee. Clin Orthop Relat Res. 1984; 185: 290-4.

  7. 7.Radin EL, Rose RM: Role of subchondral bone in the initiation and progression of cartilage damage. Clin Orthop Relat Res. 1986; 213: 34-40.

  8. 8.Harris J, Cavo M, Brophy R: Biological knee reconstruction: a systematic review of combined meniscal allograft transplantation and cartilage repair or restoration. Arthroscopy. 2011; 27(3): 409-18.

  9. 9.Matava MJ: Meniscal allograft transplantation: a systematic review. Clin Orthop Relat Res. 2007; 455: 142-57.

  10. 10.Alhalki MM, Howell SM, Hull ML: How three methods for fixing a medial meniscal autograft affect tibial contact mechanics. Am J Sports Med. 1999; 27: 320-8.

  11. 11.Fukubayashi T, Kurosawa H: The contact area and pressure distribution pattern of the knee. A study of normal and osteoarthrotic knee joints. Acta Orthop Scand. 1980; 51: 871-9.

  12. 12.Kelly BT, Potter HG, Deng XH, et al.: Meniscal allograft transplantation in the sheep knee: evaluation of chondroprotective effects. Am J Sports Med. 2006; 34: 1464-77.

  13. 13.Verdonk PC, Verstraete KL, Almqvist KF, et al.: Meniscal allograft transplantation: long-term clinical results with radiological and magnetic resonance imaging correlations. Knee Surg Sports Traumatol Arthrosc. 2006; 14: 694-706.

  14. 14.Huang A, Hull ML, Howell SM: The level of compressive load affects conclusions from statistical analyses to determine whether a lateral meniscal autograft restores tibial contact pressure to normal: a study in human cadaveric knees. J Orthop Res. 2003; 21: 459-64.

  15. 15.Lee SJ, Aadalen KJ, Malaviya P, et al.: Tibiofemoral contact mechanics after serial medial meniscectomies in the human cadaveric knee. Am J Sports Med. 2006; 34: 1334-44.

  16. 16.Paletta GA Jr, Manning T, Snell E, Parker R, Bergfeld J: The effect of allograft meniscal replacement on intraarticular contact area and pressures in the human knee. A biomechanical study. Am J Sports Med. 1997; 25: 692-8.