4.5 Article

Self-reported patient outcomes at a minimum of 5 years after allograft anterior cruciate ligament reconstruction with or without medial meniscus transplantation: An age-, sex-, and activity level-matched comparison in patients aged approximately 50 years

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W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.arthro.2006.04.104

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arthroscopy; knee osteoarthritis; allograft implantation

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Purpose: Patient outcomes at a minimum of 5 years after medial meniscus transplantation and primary anterior cruciate ligament (ACL) reconstruction via allograft tissues were compared with those of age-, sex-, and activity level-matched patients who underwent meniscal repair or partial meniscectomy and primary ACL reconstruction via allograft tissues. Methods: Eight patients (mean age 51 +/- 5 years; three women and five men) at 5.5 +/- 0.5 years after medial meniscus transplantation and ACL reconstruction (group 1) and eight matched patients (mean age, 50 +/- 5 years; three women and five men) at 5.1 +/- 0.5 years after meniscal repair or partial meniscectomy and ACL reconstruction (group 2) completed the meniscus allograft clinical registry questionnaire, which combined the modified Lysholm knee scoring scale, the 1999 International Knee Documentation Committee subjective knee evaluation, and the knee pain level score on a 10-cm visual analog scale. Results: Both groups displayed similar improvements in the modified Lysholm knee scoring scale components of pain, knee stability, squatting, stair climbing, and limping, as well as overall score (P < .05). Only group 2 displayed significant reductions in swelling. The groups displayed similar improvements in the 1999 International Knee Documentation Committee subjective knee evaluation components of sitting, rising from a chair, running, jumping, and stopping quickly, as well as overall score (P < .05). They also displayed significant improvements in the visual analog scale knee pain level score; however, group 1, which displayed greater preoperative pain levels, had considerably larger reductions. Most group 1 patients (7/8 [87.5%]) and all group 2 patients (8/8 [100%]) considered their surgery to be a success and would undergo the same procedure again if necessary. Conclusions: Although group I had greater preoperative knee pain levels, their pain levels at 5 years postoperatively were comparable to those in group 2. With the exception of swelling, comparable improvements were observed between groups for all other variables. Level of Evidence: Level III, retrospective, case-control study.

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