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Knee Surg Sports Traumatol Arthrosc. 2019 Apr 13. doi: 10.1007/s00167-019-05504-4. [Epub ahead of print]

Meniscal allograft transplantation after meniscectomy: clinical effectiveness and cost-effectiveness.

Author information

1
Division of Health Sciences, Warwick Medical School, Gibbet Hill Campus, University of Warwick, Coventry, CV4 7AL, UK. norman.waugh@warwick.ac.uk.
2
Division of Health Sciences, Warwick Medical School, Gibbet Hill Campus, University of Warwick, Coventry, CV4 7AL, UK.
3
Warwick Clinical Trials Unit, University of Warwick, Coventry, UK.
4
Effective Evidence, Waterlooville, Hampshire, UK.
5
Department of Orthopaedics, University Hospitals Coventry and Warwickshire, Coventry, UK.

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.

KEYWORDS:

Cost-effectiveness; Meniscal allograft transplantation

PMID:
30982109
DOI:
10.1007/s00167-019-05504-4

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