Description
Purpose The aim of this study was to assess how sex might affect the clinical outcome and survival of a large series of meniscus allograft transplantations (MAT), through a comparative analysis of the female and male of a large patient cohort, as well as a matched-pair analysis of homogeneous groups.
Methods A large series of patients treated with MAT was reviewed, investigating the female group and the male group with a comparative analysis of the overall cohort as well as a matched-pair analysis of homogeneous group. Inclusion criteria were: medial and lateral MAT; 2-year follow-up; unicompartmental pain due to a previous total or subtotal meniscectomy; 1-3 OA grade according to the Kellgren-Lawrence (KL) classification. Patients were evaluated at baseline and at 2 years of follow-up with the Lysholm score, the VAS scale for pain, the Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales, and the Tegner score. Surgical failure was considered as any procedure requiring partial or total MAT removal, while clinical failure as a Lysholm score <65 points.
Results: A total of 358 patients, 23.2% females and 76.8% males, were included in the analysis at 2-years follow-up. Women had significantly higher mean body mass index (BMI) (p<0.0005), poorer baseline clinical values [VAS for pain (p=0.012), Lysholm score (p=0.005), KOOS score (Symptom and Pain, p=0.034 and p=0.030 respectively) and Tegner score (pre-injury and basal, p<0.0001 and p=0.002 respectively)], a lower number of previous (p=0.039) and concurrent (p=0.001) ACL, and a higher number of concurrent procedures (p=0.032). The matched-pair analysis showed a significant difference with a higher improvement from pre-injury to final follow-up (p=0.005) and a higher mean Tegner score value at 2 years’ follow-up of (p=0.016) in men. There was a statistically significant (p=0.03) difference in the clinical survival rate between female and male patients (67.5% vs 82.2%) in the overall cohort of patients. However, this was not confirmed by the matched-pair analysis.
Conclusion: MAT in patients with post-meniscectomy syndrome presents gender differences at pre-operative assessment and at 2-year follow-up with lower results for females compared to males. However, similar results were found in the matched-paired analysis, which suggests women more frequently present unfavorable conditions for treatment success. These findings could provide valuable insights for orthopedic surgeons in identifying patients who would gain the greatest advantages from MAT.
