- Design
- Single-centre retrospective cohort
- Population
- 160 patients after meniscal allograft transplantation, median follow-up 15 years
- Primary outcome
- Graft survival
- Effect
- 84% at 10 years, 76% at 15, 69% at 20, 52% at 25
A single US institution reviewed 160 patients who had meniscal allograft transplantation between 1993 and 2020, with a minimum five-year and median 15-year follow-up. Median age at surgery was 28 and 46% were women.
Graft survival, with failure defined as resection, repair, revision or conversion to knee replacement, was 84% at 10 years, 76% at 15, 69% at 20 and 52% at 25. Forty per cent had a poor subjective knee score at final follow-up, and this clinical failure did not track graft failure. No factor predicted failure on simple analysis; after adjusting for age and cartilage grade, female sex became a significant predictor, but only just.
Only 57% of screened patients were included, which could bias survival either way. The sex finding is fragile and should not be used to deny women the operation. The survival figures are useful for counselling young patients about what to expect over decades. It was published in August 2026.
- Tell patients about 84% of grafts survive 10 years and about half survive 25.
- Explain that a surviving graft does not guarantee a good knee: 40% had poor subjective scores.
- Address cartilage and alignment at the time of transplant, since both affect outcome.
- Treat the female-sex association as uncertain; it appeared only after adjustment.
Why it matters
Young patients are choosing an operation whose results they will live with for decades.
Don't overread it
The female-sex link emerged only after adjustment in 160 patients, at p = 0.04.
The statistics, in plain English
Survival percentages come from Kaplan–Meier analysis, which estimates survival even when patients have different lengths of follow-up; the 25-year figure rests on few patients and is less certain. A p-value of 0.04 after adjustment, when the unadjusted analysis showed nothing, is weak evidence.
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