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Meniscal Allograft Reconstruction
Meniscal transplantation has acquired over the accomplished 10 years as a able technique. The acceptance that meniscal cede leads to backward access of degenerative arthritis has led board to chase for techniques to adapt the abiding after-effects of complete or subtotal meniscectomy. Meniscal allograft transplantation intends to restore meniscal action through access of acquaintance area, abatement in acquaintance stress, collective stabilization, shock absorption, and lubrication.
The break for meniscal about-face abide to evolve. Generally speaking, patients who accept undergone a subtotal or absolute meniscectomy with a abiding knee consistent and no affirmation of mal-alignment are candidates for meniscal replacement. Among patients with articular cartilage chondromalacia, the action should alluringly be bound to those with grades 1 or 2. The meniscal allograft is harvested and acquired according to standards accustomed by the American Association of Tissue Banks and is about beginning frozen. Precise allocation of the meniscal allograft is activated by accurate crabbed x-ray altitude of the antecedent after amplitude of the tibial plateau. The action is performed arthroscopically. Techniques with and after use of cartilage plugs or a cartilage arch accept been described. The attendance of cartilage plugs or arch provides the advantage of bigger adherence and cartilage to cartilage healing. This apparently after-effects in bigger bandage accent alteration and meniscal stability. The butt of the affix fixation is again performed with the meniscal adjustment address of choice.
Follow-up studies accept apparent that meniscal allografts healed to the ambit in a agnate address as archetypal meniscal repairs[66,67,68] (Figure 17). To date, the action of the crude tissue has not been established. Abiding studies that appraise the adeptness of the crude tissue to adapt the progression of degenerative changes in the postmeniscectomized knee in a -to-be appearance are bare in adjustment to actuate the abiding account of this specific procedure.
Completed meniscal replacement.
Currently, the chase is beneath way for a constructed meniscal replacement. The biomechanical backdrop of the artlessly occurring meniscus accommodate an astronomic claiming for any constructed actual to match. One meniscal backup action focuses on about-face of meniscal tissue. The approach of meniscal about-face is based on agnate scenarios for bark about-face in bake patients, as able-bodied as assumption regeneration. In the case of meniscal regeneration, a collagen arch acts as a resorbable about-face template, area the arch resorbs at a controlled amount to acquiesce for meniscal regeneration. Analytic studies investigating this address are ongoing.[69,70]
Currently, meniscal allograft transplantation, as able-bodied as meniscal regeneration, abide areas of analytic research. As such, these capacity abide arguable and there is no accord assessment with attention to their boundless analytic application.
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