Young Adults May Benefit from Meniscus TransplantationMeniscus transplants may be needed in young patients with severe damage of the knee after removing the meniscus. Without this important piece of cartilage, serious problems can develop later. The use of allograft (donated) meniscus is discussed in this article.
The authors review the normal anatomy and function of the meniscus. They also present the main ways used to preserve allograft tissue. These include fresh, cold-preserved, and freeze-dried. Fresh grafts can only be stored for about one week. Freeze-dried grafts don't reconstitute well so these aren't used anymore. That leaves fresh-frozen allografts, which aren't always available.
Meniscus transplantation is only used in patients less than 40 years old who have not been helped by other nonsurgical treatment. X-rays must show a narrowing of the joint space. Bracing to unload the joint and exercises to strengthen the muscles around the joint should be tried first.
The allograft is matched for size using X-rays and CT scans of the patient's normal knee. Arthroscopic surgery is used to evaluate the knee for the transplantation. Then open incisions are made to insert and suture the new meniscus.
The authors describe details of the surgical technique used for the transplantation. Careful placement is needed to provide proper contact points and weight distribution. The anterior
cruciate ligament is repaired at the same time if needed.
Allograft meniscal transplantation is a good option for some young patients. It restores knee function and stability and reduces pain. More studies are needed to find out what the long-term results are of this treatment method before using it routinely.
Jon K. Sekiya, MD, and Christopher I. Ellingson, MD. Meniscal Allograft Transplantation. In Journal of the American Academy of Orthopaedic Surgeons. March 2006. Vol. 14. No. 3. Pp. 164-174.
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