A meniscus is a C-shaped ring of cartilage in the knee joint. There are two menisci in each knee, one on each side. When a meniscus is badly damaged, treatment is needed to relieve knee pain and prevent future complications. Depending on the type of injury and other factors, a meniscal transplant can be an option for some people.
Our orthopedic specialists provide expert care for meniscal injuries to patients throughout the Minneapolis / St. Paul area, getting them back to their active lifestyle as quickly as possible.
Understanding What the Menisci Do
The menisci are located between the end of the thighbone, or femur, and shinbone, or tibia, within the knee joint. The medial meniscus is on the inner side of the joint, while the lateral meniscus is on the outside of the knee. The menisci are made of tough and rubbery cartilage and act as shock absorbers, providing a cushion. They also help to stabilize the knee joint.
A meniscus tear can happen due to trauma to the knee or degenerative changes in the joint over time. This type of injury is common in athletes, and a meniscus tear often happens along with other knee injuries, such as anterior cruciate ligament (ACL) tears. Older adults are also susceptible to meniscus tears as the cartilage wears down. Tears can happen from twisting the knee at an awkward angle during normal activities.
Is a Meniscal Transplant Right for You?
Meniscus tears are some of the most common orthopedic injuries, but treatment varies largely depending on the severity. In many cases, a damaged meniscus can be repaired with a surgical procedure. However, if the injury is severe, a large part of the meniscus may need to be removed. This process can lead to persistent pain in the knee and contribute to the development of osteoarthritis over time.
For older patients, a total or partial knee joint replacement is often a good option. But younger, active people might be eligible for a meniscal transplant, which can provide significant pain relief and restore stability in the knee.
To be considered for meniscal transplant surgery, you must:
- Be at a healthy weight
- Be free of rheumatoid arthritis and have no or minimal osteoarthritis
- Be missing a large portion of the meniscus due to injury or previous surgery
- Be younger than 40 years old and be physically active
- Have persistent pain with activity
- Have stable ligaments and normal alignment in the knee
To further determine if a transplant is right for you, your provider may conduct a few tests, including:
- A physical examination to test motion, strength and the stability of knee ligaments
- Ordering an MRI for imaging of the menisci, cartilage and ligaments
- Taking plain X-rays to ensure no arthritis is present as well as long-standing X-rays to evaluate the mechanical alignment of the knee
In some cases, another surgery, an osteotomy, is needed to correct misalignment prior to transplant surgery.
How Meniscal Transplant Surgery Works
In a meniscal transplant, a surgeon replaces a damaged meniscus with tissue from a deceased donor. This donor meniscus is called an allograft. Unlike other types of transplants, there is no risk of rejection with meniscal allograft transplantation. The allograft is frozen after it is harvested and sized specifically to the patient prior to surgery.
The procedure is performed arthroscopically. The surgeon makes a small incision in the knee and inserts a tiny camera to get a clear view. They then make other small incisions to insert surgical instruments. The bony portion of the graft is anchored to the patient’s knee through either bone plugs or a bony trough, and the meniscus is sutured into place.
Recovering After Meniscal Transplant Surgery
A meniscal transplant is usually done as an outpatient procedure. Following surgery, you will need to:
- Wear a knee brace and use crutches for four to six weeks. Doing so allows the new tissue to firmly attach to the bone.
- Attend physical therapy. As soon as the initial pain and swelling reduces, physical therapy can begin. In the beginning, sessions will focus on managing pain, improving range of motion and reactivating muscle. Your physical therapist will gradually add strengthening exercises as healing progresses.
Most people must wait at least two weeks before returning to work. For people with active or labor-intensive jobs, three to four months of rehabilitation may be required before starting work again. Usually, it takes six to 12 months before returning to sports or the prior activity level.
For most patients, meniscal transplant is successful, leading to significant pain relief and a full return to activity. Recent studies have shown high graft survival an average of five years after transplantation.
Schedule an appointment with an experienced provider at Summit Orthopedics to learn more about treatment options for your knee injury.
