Good News About Meniscus Grafts in Arthritic KneesKevin R. Stone, MD from The Stone Research Foundation in San Francisco, California conducted this study. The goal was to see if a meniscus allograft would survive in a severely arthritic knee. An allograft is tissue taken from a cadaver (donor after death) and transplanted into a live patient.
Earlier studies showed graft failures were common when the patient had advanced joint disease. Until now patients over age 50 or with severe arthritis weren't considered for a meniscal allograft.
But it's a catch-22 because leaving a torn meniscus alone means pain and loss of function for the patient. Taking the meniscus out results in arthritis. Meniscal allograft may offer at least one other treatment option.
All 45 patients in this study had been treated before by removing the torn meniscus. The operation is called a meniscectomy. Pain and loss of function persisted after the meniscectomy. Conservative care with drugs, therapy, rest, and exercise failed.
Patients then received a meniscus allograft. After surgery to implant the allograft, each patient followed the same rehab program. During the first four weeks, the graft site was protected as much as possible. Rehab was advanced slowly during the next four to 12 weeks. Strength training and a return to activity was the final phase.
Almost 90 percent of the meniscus allografts survived at least two years. Some lasted up to seven years. Pain, activity, and function were used as the three primary measures of success/failure. Patients who had failed implants either had the graft removed or they received a joint replacement.
The results of this study show that meniscus allograft can be used in older adults with severe arthritic changes. The author suggests previous cautions against allografts in these groups may be overstated.
Kevin R. Stone, MD, et al. Meniscus Allograft Survival in Patients with Moderate to Severe Unicompartmental Arthritis: A 2- to 7-Year Follow-up. InThe Journal of Arthroscopic and Related Surgery. May 2006. Vol. 22. No. 5. Pp. 469-478.
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