Meniscal allograft transplantation after meniscectomy: clinical effectiveness and cost-effectiveness

Knee Surg Sports Traumatol Arthrosc. 2019 Jun;27(6):1825-1839. doi: 10.1007/s00167-019-05504-4. Epub 2019 Apr 13.

Abstract

Purpose: To assess the clinical effectiveness and cost-effectiveness of meniscal allograft transplantation (MAT) after meniscal injury and subsequent meniscectomy.

Methods: Systematic review of clinical effectiveness and cost-effectiveness analysis.

Results: There is considerable evidence from observational studies, of improvement in symptoms after meniscal allograft transplantation, but we found only one small pilot trial with a randomised comparison with a control group that received non-surgical care. MAT has not yet been proven to be chondroprotective. Cost-effectiveness analysis is not possible due to a lack of data on the effectiveness of MAT compared to non-surgical care.

Conclusion: The benefits of MAT include symptomatic relief and restoration of at least some previous activities, which will be reflected in utility values and hence in quality-adjusted life years, and in the longer term, prevention or delay of osteoarthritis, and avoidance or postponement of some knee replacements, with resulting savings. It is likely to be cost-effective, but this cannot be proven on the basis of present evidence.

Level of evidence: IV.

Keywords: Cost-effectiveness; Meniscal allograft transplantation.

Publication types

  • Systematic Review

MeSH terms

  • Cost-Benefit Analysis
  • Graft Survival
  • Humans
  • Meniscectomy / adverse effects*
  • Menisci, Tibial / transplantation*
  • Osteoarthritis, Knee / etiology
  • Osteoarthritis, Knee / surgery*
  • Postoperative Complications
  • Quality of Life
  • Reoperation / economics
  • Return to Sport
  • Transplantation, Homologous / economics*