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Meniscal Transplantation

There are two C-shaped cartilage semi-lunar (moon-shaped) discs within the knee that act as shock absorbers between the end of the thigh bone (femur) and the upper part of the shin bone (tibia). These two structures are known as the medial and lateral meniscus. The menisci are vital structures that help to provide shock absorption and cushion to the knee joint with weight-bearing activities so as to dissipate the compressive stresses over the articular cartilage surface.

Tearing of the meniscus is very common during athletic activities and typically can be treated by either removing just the torn fragment or stitching the tear together. This decision is based on the size, location, and configuration of the tear. For meniscal tears that are extensive and are not amenable to repair, meniscal transplantation may be warranted prior to development of osteoarthritis. This procedure involves the placement of a donor meniscus graft that is matched specifically to the side and size of the recipient’s damaged meniscus. The surgical implantation is done through a small incision using arthroscopic methods.

Following meniscal transplantation, there is a period of restricted weight-bearing in order to allow the meniscus to heal and incorporate into the patient’s own knee. The surgery is usually performed on an out-patient basis with the risk of complications (such as infection) at less than 1%. There is a graduated return to athletic activity over the subsequent 6 to 8 months. Strenuous weight bearing activities are not recommended in order to preserve the transplanted graft, though some athletes have been able to return to high-level sports. Unlike other tissue transplantations, there is no significant rejection of a meniscal graft; therefore, anti-rejection medications are not necessary. The overall ten-year success rate for meniscal transplantation is approximately 70%.