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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

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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
Subjects: R Medicine > RD Surgery
Divisions: Faculty of Medicine > Warwick Medical School > Health Sciences > Clinical Trials Unit
Faculty of Medicine > Warwick Medical School > Health Sciences
Faculty of Medicine > Warwick Medical School
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:
DateEvent
June 2019Published
13 April 2019Available
2 April 2019Accepted
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:
Project/Grant IDRIOXX Funder NameFunder ID
UNSPECIFIEDEuropean Society of Sports Traumatology, Knee Surgery and Arthroscopyhttp://viaf.org/viaf/134546733

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