Meniscal allograft transplantation

Definition

Meniscal allograft transplantation is surgery in which a meniscus -- a c-shaped cartilage in the knee -- is placed into your knee. The new meniscus is taken from a person who has died (cadaver) and donated their tissue.

Alternative Names

Meniscus transplant; Surgery - knee - meniscus transplant; Surgery - knee - cartilage; Arthroscopy - knee - meniscus transplant

Description

If your doctor finds that you are a good candidate for a meniscus transplant, x-rays or an MRI of your knee is usually taken to find a meniscus that will fit your knee. The donated meniscus is tested in the lab for any diseases and infection.

Other surgeries, such as ligament or cartilage repairs, may be done at the time of the meniscus transplant or with a separate surgery.

You will likely receive general anesthesia before this surgery. This means you will be asleep and unable to feel pain. Or, you may have regional anesthesia. Your leg and knee area will be numbed so that you do not feel any pain. If you receive regional anesthesia, you will also be given medicine to make you very sleepy during the operation.

During the surgery:

After the surgery is finished, the incisions are closed. A dressing is placed over the wound. During arthroscopy, most surgeons take pictures of the procedure from the video monitor to show you what was found and what was done.

Why the Procedure Is Performed

Two cartilage rings are in the center of each knee. One is on the inside (medial meniscus) and one is on the outside (lateral meniscus). When a meniscus is torn, it is commonly removed by knee arthroscopy. Some people can still have pain after the meniscus is removed.

A meniscus transplant places a new meniscus in the knee where the meniscus is missing. This procedure is only done when meniscus tears are so severe that all or nearly all of the meniscus cartilage is torn or has to be removed. The new meniscus can help with knee pain and possibly prevent future arthritis.

Meniscus allograft transplantation may be recommended for knee problems such as:

Risks

Risks for anesthesia and surgery in general are:

Risks for meniscal transplant surgery are:

Before the Procedure

Tell your health care provider what medicines you are taking. This includes medicines, supplements, or herbs you bought without a prescription.

During the 2 weeks before your surgery:

On the day of surgery:

After the Procedure

Follow any discharge and self-care instructions you are given.

After the surgery, you will probably wear a knee brace for the first 6 weeks. You will need crutches for 6 weeks to prevent putting full weight on your knee. You will likely be able to move the knee right after surgery. Doing so helps prevent stiffness. Pain is usually managed with medicines.

Physical therapy can help you regain the motion and strength of your knee. Therapy lasts for between 4 and 6 months.

How soon you can return to work depends on your job. It can take from a few weeks to a few months. It can take 6 months to a year to fully return to activities and sports.

Outlook (Prognosis)

Meniscus allograft transplantation is a difficult surgery, and the recovery is hard. But for people who are missing the meniscus and have pain, it can be very successful. Most people have less knee pain after this procedure.

References

Maak TG, Rodeo SA. Meniscal injuries. In: Miller MD, Thompson SR, eds. DeLee and Drez's Orthopaedic Sports Medicine: Principles and Practice. 4th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 96.

Phillips BB, Mihalko MJ. Arthroscopy of the lower extremity. In: Azar FM, Beaty JH, Canale ST, eds. Campbell's Operative Orthopaedics. 13th ed. Philadelphia, PA: Elsevier; 2017:chap 51.