Biomechanics of Meniscal Allograft Transplantation: A Meta-Analysis

Introduction. Despite trends to repair meniscal defects, meniscectomy continues to be a common procedure. Degenerative changes following these surgeries become candidates for meniscal allograft transplantation. Purpose. The purpose of this meta -analysis was to review published articles that compared methods of meniscal allograft transplantation (bone plug, suture only, or bone bridge) for their biomechanical effects on tibiofemoral mean contact pressure and contact area in relation to intact meniscal states. Materials and methods. PubMed database search on July 15, 2020 for articles evaluating the knee kinematics of MAT in a biomechanical model. Results. The greatest contact area was found in the setting of an intact meniscal state, with a mean difference of 188.886 mm(3) (95%CI 148.059-229.672, p < 0.001) and 78.713 (95%CI 78.713-103.733, p < 0.001), when compared to meniscectomy and MAT respectively. Although MAT showed a lower contact area vs the intact knee, it did have a greater contact area than meniscectomy by 94.951 mm(2) (95%CI, 71.590118.312, p < 0.001). The dovetail bone bridge technique was shown to have the highest difference in mean contact area of 207.676 mm(2) (95%CI 85.288-330.065, p < 0.001) when compared to bone plug technique. Conclusions. Meniscal allograft transfer demonstrated significantly less contact area than a meniscus intact knee and significantly higher contact area than meniscectomy. In the systematic review, bone bridge meniscal allograft transplant techniques offered the closest reproduction of native knee biomechanics when compared to bone plug and suture only.