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MENISCAL ALLOGRAFT TRANSPLANTATION (MAT)

MENISCAL ALLOGRAFT TRANSPLANTATION (MAT). "“ Preliminary results. Clinical protocol” Drs. J.D. Ayala Mejías, 1 L. Alcocer, 1 A. Estévez, 2 R. Canosa, 3 C. Gavín, 3 C. Vidal 4 1. Hospital Monográfico de Traumatología, Cirugía Ortopédica y Rehabilitación. ASEPEYO. Coslada, Madrid.

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MENISCAL ALLOGRAFT TRANSPLANTATION (MAT)

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  1. MENISCAL ALLOGRAFT TRANSPLANTATION(MAT) "“Preliminary results. Clinical protocol” Drs. J.D. Ayala Mejías,1 L. Alcocer,1 A. Estévez,2 R. Canosa,3 C. Gavín,3 C. Vidal 4 1. Hospital Monográfico de Traumatología, Cirugía Ortopédica y Rehabilitación. ASEPEYO. Coslada, Madrid. 2. Clínica Nuestra Sra. de América. Madrid. 3. Hospital Fundación Alcorcón. Madrid. 4. Hospital Universitario 12 de Octubre. Madrid.

  2. “GRUPO DE ESTUDIO DE MADRID” PROTOCOL Drs. Luis Alcocer, Juan Ayala Mejías (Hospital Monográfico de Traumatología, Cirugía Ortopédica y Rehabilitación. ASEPEYO. Madrid) Canosa R, Gavín C. (Fundación Hospital Alcorcón) Estévez A. (Clínica N. S. de América) Vidal C. (Hospital Universitario 12 de Octubre)

  3. PREOPERATIVE PROTOCOL Donor measurements • Meniscus • Tibial plateau Recipient measurements • True PA and lateral xray • CT: tibial plateau

  4. INDICATIONS • Total meniscectomy , body and posterior horn • Age: < 55 y-o. • Sports and physical activities • Local untractable pain • No instability (?) • Normal axial limb aligment (?) • Outerbridge I and II grade (III, IV?)

  5. Material and method 11 cases (4 rejected < 12 m f/u) OR Nov. 2001 – Jul 2003 Mean F/U (months) = 13.6; r(8,22) Labour activ.

  6. Material and method

  7. Material and method Months post-meniscectomy 35 (2 – 90) Nº of previous arthroscopies 2.3 (1-5)

  8. Tibial plateau measurements (mean) Donor 35 mm x 49 mm Patient 32 mm x 46 mm

  9. Material and method

  10. Material and method Outerbridge chondral lesions

  11. IKDC: subjective assessment

  12. IKDC: objective assessment

  13. IKDC: objective assessment

  14. Follow-up: arthroscopy • 2 revision arthroscopy • arthrofibrosis (4th month) • infection vs. inmunologic response • (11th month)

  15. Follow-up: arthroscopy/MRI • Revision MRI (5 cases) • 5 peripherically healed • 4 body and/or anterior horn extruded • 5 intrasubstance degeneration

  16. Follow-up: MRI 6th month post-op

  17. Follow-up: MRI 6th month post-op

  18. OUR SURGICAL TECHNIQUE • With or without bone plugs (?) • Peripheral groove for medial meniscus • Contralateral tunnels • Posterior horn suture (Fast Fix® MI, Sharp Shutter® ME) • Meniscus body (Sharp Shutter®) • Anterior horn suture (outside-in)

  19. CONCLUSIONS • Promissing byological and mechanical results • Good preliminary clinical results • “Dissappointing” mid-term results (5-10 years)

  20. ¡MUCHAS GRACIAS! THANK YOU !

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