Open AccessMeniscal allograft transplantation after meniscectomy: clinical effectiveness and cost‐effectiveness
Author(s) -
Waugh Norman,
Mistry Hema,
Metcalfe Andrew,
Loveman Emma,
Colquitt Jill,
Royle Pamela,
Smith Nick A.,
Spalding Tim
Publication year - 2019
Publication title -
knee surgery, sports traumatology, arthroscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.806
H-Index - 125
eISSN - 1433-7347
pISSN - 0942-2056
DOI - 10.1007/s00167-019-05504-4
Subject(s) - medicine , cost effectiveness , observational study , transplantation , surgery , osteoarthritis , clinical effectiveness , evidence based medicine , quality of life (healthcare) , physical therapy , randomized controlled trial , risk analysis (engineering) , alternative medicine , nursing , pathology
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.