Centralized anterior bone plug results in less graft extrusion in patients undergoing medial meniscus allograft transplantation following anterior cruciate ligament reconstruction.

PURPOSE This study was performed to analyze the effect of anterior bone plug positioning on clinical and radiological outcomes in patients undergoing medial meniscus allograft transplantation (M-MAT) following anterior cruciate ligament reconstruction (ACLR). METHODS Data from 24 patients who underwent M-MAT following meniscectomy and ACLR from November 2008 to June 2017 were retrospectively investigated. Patients were divided into either the centrally positioned group (group C) or the medially positioned group (group M) based on the location of the anterior bone plug for M-MAT. Clinical and radiographic follow-up was performed at two years postoperatively. International Cartilage Repair Society (ICRS) grades of chondral lesion, graft extrusion, and meniscus signal intensity were evaluated by magnetic resonance imaging (MRI) at one year postoperatively. RESULTS There were no significant differences in demographics including follow-up time of two years between the two groups. There were no significant differences in postoperative subjective International Knee Documentation Committee (IKDC), Lysholm, and Tegner scores between groups. Furthermore, there were no significant differences in osteoarthritis progression or ICRS grade on MRI. However, group C showed significantly less absolute graft extrusion (P = .008) and relative graft extrusion (P < .0001) on one-year follow-up MRI, relative to group M. Meniscus signal intensity tended to be better in group C, although this difference was not statistically significant (P = .092). CONCLUSION The centrally positioned group showed significantly less graft extrusion on MRI compared to the medially positioned group; however, there were no statistically significant differences in clinical outcomes between the two groups.