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Meniscus Transplant
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Meniscus Transplant

In the knee joint, the meniscus are basically C-shaped discs that act as a ‘shock absorber’ and stabiliser between the thigh bone and the shin bone. The knee has two menisci, one on the ‘medial’ side, or inside, and one on the ‘lateral’ side, or outside.

The primary job of the meniscus is to distribute the load evenly across the cartilage when people walk, run or do anything that involves impact. The menisci perform some other secondary roles, which include aiding in the stability of the knee along with the cruciate and collateral ligaments.

When someone injures their meniscus and it reduces in size by over 50%, the shock absorbency patterns of the knee joint become compromised. If people are not careful, this may lead to the early development of arthritis.

Intended audience

This article is intended for anyone suffering from damage to their meniscus and articular cartilage and their families who would like to find out about meniscus transplant, as well as anyone interested in cartilage problems.

What is Meniscus Transplant?

When a patient has had a serious enough injury to their meniscus in which they lose the majority of the meniscal tissue, it may not function very effectively any more. This can result in pain and the entire meniscus can then be replaced.

When the meniscus is replaced, or transplanted, donated tissue known as an ‘allograft’, is used. For example, when people donate their hearts, livers, kidneys, they also donate their bones, tendons, and meniscal tissue.

One of the nice things when tissue of this type is donated is that there is time to make sure it is in good condition and test it for different types of bacteria, fungi and viruses. Unlike a kidney or a liver, which has to be used within the first 24–48 hours, this kind of tissue does not have to be used as quickly. It can therefore be tested and quarantined until all the tests come back negative.

When the orthopaedic surgeon sees a patient whom may need a meniscal transplant, they take X-rays with markers on so that the top of the tibial plateau can be measured. Those measures are then sent to the tissue bank company, and they find a match. For example, if it is a right knee and they are looking for the medial meniscus to match the patient’s tissue, they will usually match the tissue to within 1%–2% of the size, both front to back and side to side. Alternatively, an MRI scan of the opposite knee may be used to measure it.

Once there is a size matched meniscal allograft found, the meniscus is implanted into the patient via an arthroscopy or mini open incision. The meniscus allograft is then anchored in place, which will then heal and become the new meniscus.

Figures

Torn Meniscus

What outcomes can patients expect from meniscus transplant?

From a functional standpoint, people can get back to a fairly active lifestyle after a meniscus transplant.

Although the meniscus transplant works very well, it is certainly not as good as the original. It is therefore probably not going to last forever, and people should understand that this may not be their last operation.

The majority of the studies suggest that good or excellent results can be expected in around 85% of patients. Like everything else, it is not going to last forever, but the procedure may delay the knee becoming significantly arthritic.

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