A meniscus transplant, also known as meniscal allograft transplantation, is an advanced and innovative surgery used when the meniscus is severely damaged or has been removed. If a patient has significant loss or damage of the meniscus from an injury or from multiple surgeries, a meniscus transplant can relieve pain, restore function and preserve the knee. Without the meniscus functioning as a shock absorber between the knee joint, the articular cartilage of the knee can degenerate overtime causing osteoarthritis to develop. By transplanting a new meniscus into the knee before arthritis has developed, the goal is to delay the onset of arthritis related knee pain as well as eliminate the need for further surgery.
Optimal candidates for a meniscus transplant are individuals who are meniscal deficient. This means that these patients are either missing a meniscus due to prior surgery or have a severely damaged meniscus that no longer functions to cushion the knee joint. Additionally, this procedure is most successful for patients who have normal or minimal degenerative arthritic changes to the articular cartilage of the knee at the time of surgery. Other factors like age, activity level, ligament instability and alignment of the knee must also be considered before surgery is recommended.
Before surgery, your surgeon will discuss the surgical treatment plan and outcomes with you. Pre-operative x-rays of your knee will be taken in order to size a new meniscus specifically for your knee joint. The meniscus allograft used is donor tissue taken from a cadaver. As with any transplanted tissue, there is a very minimal risk of disease transmission but screening processes reduce this risk even further. Meniscal transplant surgery is not a decision to be taken lightly and needs planning, commitment, and rehabilitation to have a successful and positive outcome.
Meniscal transplant surgery is both an arthroscopic and open procedure. Knee arthroscopy involves making 2-3 small incisions around the knee joint where the arthroscope or camera and other small surgical instruments can be inserted. The surgeon can then view the inside of the knee to be able to evaluate the ligaments, cartilage, and menisci. At this time the surgeon can also identify and repair any other damage or injuries to the knee. If there is any remaining meniscus, it will be removed by using special instruments. The new meniscus will then be sized to fit into your knee and inserted through a larger incision made in the front of your knee. The meniscus is then attached in the right location using either bone plugs or ridge of bone and sutures. A meniscus transplant is a highly skilled and complex surgery that only a handful of trained surgeons can successfully perform. The goal of this procedure is for the patient to successfully return to full athletic activity at 6 – 12 months. A general guideline for Meniscus Transplant rehabilitation can be found within the Rehabilitation Protocols.