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Meniscus Allograft Transplantation
The meniscus is a c-shaped wedge of tissue in your knee, between the thighbone (femur) and the shinbone (tibia). There are two menisci, medial and lateral, and they function much like gaskets, or shock absorbers, cushioning the knee. They also serve a very important role in lubrication of the knee joint, and aiding in normal knee motion. The meniscus helps to protect the cartilage surface of the knee, and help prevent arthritis.
Unfortunately, the meniscus is easily and often torn, and rarely heals on its own. See meniscus tears. Occasionally the torn meniscus can be repaired arthroscopically, but the vast majority of meniscus tears will not heal with surgical repair. Instead, the most common treatment for a torn meniscus is aknee arthroscopy, with trimming out of the torn meniscus fragment. This is usually highly successful, and most patients recover their normal knee function.
Sometimes the meniscus sustains a very large tear which cannot be repaired, and most or all of it must be removed. This leaves the knee with greatly reduced shock absorbency, and increased stress across the knee joint. The knee without a meniscus is at a much higher risk of wearing out the cartilage coating on the end of the knee bones, resulting in painful arthritis, and further surgery including a total knee replacement.
Until recently, little could be done for the knee that had had most of a meniscus removed, other than limit activity, wait, and hope. Now we have the ability to replace the meniscus with a meniscus allograft transplantation.
The removed meniscus is replaced with a cadaver meniscus, called an allograft. This donor tissue is thoroughly tested to make sure it is completely free of any disease, and is specifically sized to the recipient patient. The new meniscus is then sutured into the patient’s knee, either through an open procedure or arthroscopically, and after a careful rehabilitation, full activities are resumed. Almost all of these meniscus transplantations heal with few, if any problems.
This procedure, while very new, offers real hope to the young patient who has sustained a large irreparable meniscal tear.
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