Meniscal Transplantation

What is a meniscus?

The meniscus is a rubbery, C-shaped disc that cushions your knee. Each knee has two menisci (plural of meniscus), one at the outer edge of the knee and one at the inner edge. Meniscal tears are one of the most common knee injuries.

The menisci serve several important functions in the knee:

  • They provide stability
  • They act as a cushion
  • They dissipate forces throughout the joint
  • They ensure overall joint health

What is a meniscal transplant?

A meniscal transplant is a surgical procedure in which the damaged meniscus is taken out and replaced with a donor meniscus.

When is a meniscal transplant recommended?

In most cases, the surgeon should repair a meniscal tear whenever possible. In some circumstances, however, the menisci may be impossible to repair. If that is the case, your specialist may recommend a meniscal transplant.

Meniscal transplantation is a reasonable option in young, active patients with symptomatic meniscal deficiency after a large portion of the meniscus has been removed.

How do I know if I need a meniscal transplant?

Before recommending meniscal transplantation, your doctor will carefully evaluate your specific condition:

  • Your history is taken into consideration, including previous surgeries and whether previous meniscal repair or meniscectomy was performed.
  • Your specialist will also complete a physical examination to test motion, strength, and the stability of knee ligaments.
  • X-rays are taken to ensure that there is no arthritis.
  • Long leg standing X-rays are performed to evaluate your mechanical alignment.
  • An MRI scan provides information about the menisci, cartilage, and ligaments.

Who is a good candidate for meniscal transplantation?

  • Meniscal transplantation is recommended in patients less than 40 years old with an absent or nonfunctioning meniscus.
  • Patients have symptoms that include:
    • Pain on the side of the deficient meniscus
    • Swelling
    • Difficulty with activities of daily living or sports

Meniscal transplant is not recommended for patients with the following conditions:

  • Malalignment
  • Ligament instability
  • Significant damage to the cartilage

How is a meniscal transplant performed?

  • First, a medial or lateral meniscal allograft is obtained from a cadaver.
  • The graft is sized specifically to the patient before surgery and is deep-frozen after harvest.
  • The surgical procedure is performed arthroscopically.
  • The bony portion of the graft is attached to the patient’s knee through either bone plugs or a bony trough.
  • The meniscus is then sutured into place.

What can I expect after surgery?

After surgery, there are several guidelines you’ll need to follow to maximize your recovery.

  • For six weeks after surgery, you can expect to be on crutches.
  • You’ll meet with a physical therapist for four to six months after surgery to work on motion, strength, and neuromuscular control.
  • Patients are typically cleared to return to sports six to nine months after surgery.

This procedure can predictably relieve pain and restore knee stability. Recent studies have shown high graft survival at an average of five years after transplantation.

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