Colorado Orthopedic News

Meniscus Transplant

Meniscus Transplant

Knee pain can derail anyone’s life. Especially if it is from a torn, damaged, or missing meniscus, which is crucial to knee stability and provides cushioning to the knee joint, as well as distributing weight and stress within the joint. A meniscus transplant replaces damaged cartilage, relieves knee pain, and improves the way the knee works. It can also prevent osteoarthritis from developing early in life. That’s why you need to see the best orthopedic knee specialists as soon as possible, like those at Advanced Orthopedic & Sports Medicine Specialists in Denver, Parker, or Aurora, Colorado. You don’t need to suffer a minute more.

OVERVIEW

It is important to note that a surgical meniscus transplant is not a commonly performed surgery. This is largely due to the strict criteria patients must meet to be considered for the procedure. A provider may recommend this procedure if the meniscus is severely damaged or if the meniscus has been removed (meniscectomy) after a previous injury. There are other reasons to get a meniscus transplant which is also referred to as a meniscal allograft transplantation (MAT). This surgery is less invasive than knee replacement surgery which makes it a good choice for active people who are younger than 40. While a meniscal transplant can prevent or delay osteoarthritis from developing, the procedure will not help people who already have knee pain from arthritis. A meniscus transplant is not like a heart or lung transplant, in which “rejection” can occur. Additionally, patients do not need to be on immunosuppressants or other medications after the procedure.

WHAT ARE THE MENISCI?

The meniscus is a C-shaped piece of cartilage in the knee. The are two of them (menisci) in each knee, one on the inside (medial) and one on the outside (lateral). Important shock absorbers in the knee, these rubbery pieces of cartilage cushion the knee joint and protect the leg bones as they move. The knee is subjected to up to 5 times body weight during activity, and half this force is transmitted through the meniscus with the knee straight, and 85% of the force goes through the meniscus with the knee bent ninety degrees. Loss or damage of the meniscus increases the pressure on the articular  (gliding) cartilage, which eventually leads to degenerative change.

WHAT IS A MENISCUS TRANSPLANT?

The goal of meniscus transplant surgery is to replace the meniscus cushion before the articular cartilage is damaged. In a meniscus transplant, healthy cartilage tissue is taken from a cadaver (human donor) and frozen. This tissue is called an allograft. It is sized, tested for disease, and stored. Correct sizing is one of the most important factors in the success of the transplant. Later, the allograft will be matched by size to a candidate for the procedure. Once selected, the donor tissue undergoes many tests. The safety of the tissue is monitored by the American Association of Tissue Banks and the United States Food and Drug Administration. A meniscus transplant is a minimally invasive surgery usually done with knee arthroscopy, one of the most commonly performed surgical procedures where the surgeon inserts a miniature camera through a small incision (portal) in the knee. This provides a clear view of the inside of the knee. They then insert surgical instruments through other small incisions to perform the procedure. The new meniscal tissue is anchored into the shinbone to stabilize the transplant. More stitches are placed into the meniscal transplant to sew it into place and attach it to the knee capsule.

WHO QUALIFIES FOR A MENISCUS TRANSPLANT?

Strict patient criteria must be met to be considered for a meniscus transplant, such as:

  • Articular cartilage must be intact (or reconstructable) without excessive damage
  • Patients need to be younger than 55 and physically active
  • More than half of the meniscus is damaged as a result of a previous surgery, injury, or a tear that cannot be repaired
  • Pain with activity that is persistent
  • Patient must have stable ligaments with normal bone alignment (or if instability or alignment are factors – these need to be addressed).
  • Patient may not be obese

SYMPTOMS

Some common symptoms of a damaged meniscus include:

  • A popping sensation when the injury occurs
  • Swelling or stiffness
  • Pain, especially when twisting or rotating the knee
  • Difficulty fully straightening the knee
  • Locked” feeling when trying to move the knee

Knee osteoarthritis and torn meniscus tend to cause certain similar symptoms. These overlapping symptoms are often a source of confusion, leading people to incorrectly self-diagnose or delay treatments.

NON-SURGICAL TREATMENTS

  • Rest, Ice, Compression, and Elevation (the RICE regimen)–Resting the knee can help relieve symptoms. A can may be used for a few weeks to keep weight off the knee. Ice applied periodically can reduce swelling. Wearing a compression bandage may also reduce swelling.
  • Pain Relief Medications–Nonsteroidal anti-inflammatory medications such as ibuprofen and naproxen can help to reduce inflammation and pain. Acetaminophen can help manage pain but does not reduce inflammation.
  • Physical Therapy–If inflammation in the joint subsides and one can walk without pain, physical therapy can help rebuild strength and flexibility in the injured knee.
  • Corticosteroid Injections–corticosteroids are powerful anti-inflammatory medications injected directly into the knee. These powerful anti-inflammatory medications may reduce swelling and discomfort for a longer time.

WHEN IS SURGERY INDICATED?

A Meniscus transplant may be the best option if conservative measures don’t help. It is also the best option if the meniscus was removed in a previous surgery, more than half the meniscus is missing, there is a large meniscus tear that is irreparable, there is significant or persistent pain with activity or one has an unstable knee.

GETTING THE RIGHT DIAGNOSIS. GETTING THE RIGHT DOCTOR.

Because of the complexity involved in the process of getting a meniscus transplant, it is critical to select an orthopedic knee surgeon who is highly trained and experienced in performing this procedure to help guarantee a successful recovery and outcome. You need look no further than the orthopedic experts you’ll find at Advanced Orthopedics in Denver, Parker, or Aurora, Colorado. If after a thorough examination and imaging tests your surgeon finds that you are a good candidate for a meniscus transplant, scans of your knee are taken to size your knee to find a meniscus to fit your knee perfectly. At Advanced Orthopedics, their skill, attention to detail, and level of overall care for their patients results in successfully getting you active again and enjoying life with little or no pain. Schedule an appointment today if you are experiencing knee pain.

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