Risk Factors for Graft Failure After Meniscal Allograft Transplantation: A Systematic Review and Meta-analysis

Kunze KN, Davie RA, Ramkumar PN, Chahla J, Nwachukwu BU, Williams RJ 3rd · Orthopaedic Journal of Sports Medicine

Pooled failure at latest follow-up was 17.8%, with individual studies from 3.3% to 81.0%. Ten studies reporting at five years pooled to 10.9% (range 4.7% to 23%), and four reporting at ten years pooled to 22.7% (range 8.1% to 55.0%). Of thirty-nine candidate risk factors, only three could be pooled: cartilage damage worse than ICRS grade 3a at the time of surgery raised the odds of failure more than fivefold (OR 5.32, 95% CI 2.75 to 10.31, p<0.001), while patient sex (OR 2.16, 95% CI 0.83 to 5.64, p=0.12) and which side the graft went into (OR 1.11, 95% CI 0.38 to 3.28, p=0.85) did not separate.

Population

Seventeen studies covering 2,184 patients who had a meniscal allograft transplantation, at any length of follow-up

Intervention

Meniscal allograft transplantation of the knee

Comparator

Failed against non-failed grafts within the included studies

Limitations

Level 4 evidence pooled from case series, quality assessed with MINORS rather than a randomised-trial instrument. The failure ranges are very wide because failure is defined differently from study to study, so the pooled figures describe a spread more than a rate. Thirty-six of the thirty-nine risk factors examined could not be pooled at all and are described narratively. Author disclosures include grant support, education payments and consulting fees from orthopaedic device manufacturers; no funding for the review itself is declared.