The surgeon makes several small incisions around the knee joint and inserts a narrow fiber optic scope (called an arthroscope) to examine the condition of the knee. Tiny instruments are used to remove any fragments of original meniscus cartilage. The new meniscal tissue is anchored into the shinbone to stabilize the transplant and then sewn into place.
Meniscal transplant surgery is rare and not for everyone. Good candidates are active people under the age of 55 who are missing more than half a meniscus or have a severe meniscus tear that cannot be repaired. For older patients or those with developed osteoarthritis, a knee replacement is often a better option.
Anatomy
The meniscus is a rubbery, C-shaped piece of cartilage that cushions the knee, provides stability and helps distribute body weight across the knee joint. Each knee has two menisci, one at the outer edge (the lateral meniscus) and one at the inner edge (the medial meniscus). When the meniscus is removed, articular cartilage can wear away, leading to degenerative changes and early arthritis of the knee joint.
When is surgery recommended?
Most meniscal tears are either removed or repaired. However, in special circumstances, allograft (cadaver) transplantation of meniscal tissue is possible. Patients must meet strict criteria, including:
- Younger than 55
- Physically active with a normal BMI
- Missing more than half a meniscus from a previous surgery or injury
- Persistent pain
- Minimal degenerative joint changes
What is the recovery time?
Full recovery from meniscal transplant surgery can take up to six months. Patients must spend the first four to six weeks in a knee brace and on crutches to give the transplanted tissue time to attach to the bone. A physical therapy program is recommended to restore flexibility, strength and range of motion.
Time off from work can last from several weeks to several months, depending on job requirements. Return to sports and other activities varies by patient and demand.