Meniscal Transplants
The meniscus is a C-shaped cartilage cushion in the knee joint that helps the joint bear weight, glide and turn. Each knee has two menisci, one on each side, that serve as shock absorbers. An orthopedic surgeon may be able to repair a damaged or torn meniscus. However, a meniscus that is badly damaged or has an extensive tear may have to be removed. Without the menisci, a knee joint can develop persistent pain, swelling and arthritis.
In older patients, a knee joint replacement is an option. But for younger individuals a meniscal transplant is an alternative to replacing the entire joint. A meniscal transplant uses donor tissue to replace the damaged meniscus. This procedure is still relatively uncommon and is not appropriate for all patients. However, patients who qualify can benefit from a meniscal transplant.
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A meniscal transplant may be recommended for people who meet the following criteria:
- Physically active and relatively young, under age 55
- Missing more than half of the meniscus due to surgery or injury or has a tear that cannot be repaired
- Continues to have activity-related pain in the knee
- Has little or no evidence of arthritis in the knee
The transplanted tissue comes from human donors. Healthy tissues are frozen and matched by size to the candidate. As of today, there is no synthetic meniscal tissue. The safety of donor tissue is strictly monitored by the Food and Drug Administration and the American Association of Tissue Banks. Before the transplant is performed, the donor tissue is tested to make sure it is disease-free. Tissues are tested to ensure that they do not have any traces of infectious diseases such as hepatitis or HIV/AIDS. These tests help reduce the risk of contamination.
A meniscal transplant is an outpatient procedure performed using tiny instruments and a small incision (arthroscopic surgery). A regional anesthetic is used. The surgeon will make one small incision in the knee joint, with two or three other "nicks" to help situate the transplant properly. These secondary incisions are so small that they may not even require sutures to close them. The new meniscal tissue is anchored to the tibia, the larger bone in your lower leg.
For the first three to four weeks after surgery, crutches and a knee brace will be needed. This gives the transplanted tissue time to become firmly attached to the bone. If you work in an office and have a basically sedentary job, you should be able to return to work a week after your surgery. If you have a more active job, you may not be able to resume all your job duties for two to three months. Certain activities such as squatting, bicycling and swimming will need to be avoided for at least six months.