Incidence and Extent of Graft Extrusion following Meniscus Allograft Transplantation

Background. The incidence and extent of graft extrusion after meniscus allograft transplantation (MAT) may differ in patients undergoing medial and lateral meniscus transplantation due to the use of different surgical techniques. This meta-analysis was therefore designed to quantify the extent and incidence of graft extrusion after meniscus allograft transplantation. Methods. Following preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, all studies reporting absolute extrusion, relative percentage of extrusion (RPE), or frequency of major extrusions (>3 mm) on magnetic resonance imaging in patients undergoing medial or lateral MAT were included. Results. The pooled mean absolute extrusion following all MATs was 3.15 mm but was significantly greater following medial than lateral MAT (3.26 versus 3.01 mm; p=0.001). The pooled mean RPE following all MATs was 32.79% and was significantly greater after medial than lateral MAT (32.69% versus 28.81%; p<0.001). The pooled mean proportion of knees with major (>3 mm) extrusion was 53% (95% CI: 49% to 58%) and was significantly greater after medial than lateral MAT (61% versus 39%; p<0.001). Conclusion. Mean graft extrusion after arthroscopic assisted MAT using bony fixation was 3.2 mm, with major graft extrusion > 3 mm occurring in about 50% of transplanted menisci. Graft extrusion was significantly greater after medial than lateral MAT.