TRASPLANTE DE MENISCO

1
(No Transcript)
2
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.

3
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)
4
PREOPERATIVE PROTOCOL

• Donor measurements
• Meniscus
• Tibial plateau
• Recipient measurements
• True PA and lateral xray
• CT tibial plateau

5
INDICATIONS

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

6
Material and method
11 cases (4 rejected lt 12 m f/u) OR Nov. 2001
Jul 2003 Mean F/U (months) 13.6 r(8,22)
Labour activ.
7
Material and method
8
Material and method
Months post-meniscectomy 35 (2 90) Nº of
previous arthroscopies 2.3 (1-5)
9
Tibial plateau measurements (mean) Donor 35 mm
x 49 mm Patient 32 mm x 46 mm
10
Material and method
11
Material and method
Outerbridge chondral lesions
12
IKDC subjective assessment
13
IKDC objective assessment
14
IKDC objective assessment
15
Follow-up arthroscopy

• 2 revision arthroscopy
• arthrofibrosis (4th month)
• infection vs. inmunologic response
• (11th month)

16
Follow-up arthroscopy/MRI

• Revision MRI (5 cases)
• 5 peripherically healed
• 4 body and/or anterior horn extruded
• 5 intrasubstance degeneration

17
Follow-up MRI
6th month post-op
18
Follow-up MRI
6th month post-op
19
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)

20
CONCLUSIONS

• Promissing byological and mechanical results
• Good preliminary clinical results
• Dissappointing mid-term results (5-10 years)

21
MUCHAS GRACIAS! THANK YOU !