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Meniscal allograft transplantation after meniscectomy : clinical effectiveness and cost-effectiveness
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Waugh, Norman, Mistry, Hema, Metcalfe, Andrew J., Loveman, Emma, Colquitt, Jill, Royle, Pamela, Smith, Nick A. and Spalding, Tim (2019) Meniscal allograft transplantation after meniscectomy : clinical effectiveness and cost-effectiveness. Knee Surgery, Sports Traumatology, Arthroscopy, 27 (6). pp. 1825-1839. doi:10.1007/s00167-019-05504-4
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Official URL: http://dx.doi.org/10.1007/s00167-019-05504-4
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.
| Item Type: | Journal Article | ||||||||
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| Subjects: | R Medicine > RD Surgery | ||||||||
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Homografts, Meniscus (Anatomy) -- Surgery | ||||||||
| Journal or Publication Title: | Knee Surgery, Sports Traumatology, Arthroscopy | ||||||||
| Publisher: | Springer | ||||||||
| ISSN: | 0942-2056 | ||||||||
| Official Date: | June 2019 | ||||||||
| Dates: |
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| Volume: | 27 | ||||||||
| Number: | 6 | ||||||||
| Page Range: | pp. 1825-1839 | ||||||||
| DOI: | 10.1007/s00167-019-05504-4 | ||||||||
| Status: | Peer Reviewed | ||||||||
| Publication Status: | Published | ||||||||
| Access rights to Published version: | Restricted or Subscription Access | ||||||||
| RIOXX Funder/Project Grant: |
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