What Is Meniscal Transplantation

Details of who is a suitable candidate for this type of surgery, what the surgery entails and an overview of results of surgery.

The operation inserts a donor meniscus, supplied by a tissue bank storing donor allograft tissue, into the knee to replace the old damaged/absent meniscus.

The meniscus is a C-shaped cartilage structure in the knee that sits between the smooth surfaces on the ends of the thigh bone (femur) and the shin bone (tibia). There is one in the inner (medial) side and one in the outer (lateral) side. Its role is to cushion or share the weight that is transmitted through the knee joint. Damage to the meniscus from an injury can mean that some has to be taken away (partial meniscectomy operation). Repeated damage or a bigger injury can lead to large tears that cannot be repaired. Removal of the damaged meniscus may be the only option but this exposes the knee joint to excessive loads that can cause pain.

The aim of the meniscal transplant operation is to place a meniscus back into the joint to act as a new shock absorber, to try to reduce the pain on weight bearing activity and to try to protect the knee joint from damage and ultimately arthritis. The meniscus graft is obtained from a donor tissue bank and is chosen specifically size matched to the knee

The procedure is indicated in patients who have pain or problems in the affected compartment in the knee due to deficiency of the meniscus or where replacement of the meniscus may help with other procedures to reconstruct a damaged knee.

EXPECTATIONS AND RESULTS: In the short term 8-9 out of 10 patients should expect improvement in knee pain and activity levels after surgery and rehabilitation. In 1 in 10 the donor meniscus may not heal fully and may re-tear or cause further pain requiring surgery. Details on complications are given in this information sheet.

Long term results are less well known but further symptoms in the knee are expected over time due to the nature of the knee injury.

DETAIL OF THE OPERATION: During the operation, the graft is inserted through incisions at the front of the knee, slightly larger than the incisions from previous arthroscopic surgery. There will also be an incision on the side of the knee at the level of the joint. Other incisions will be made according to the pre agreed plan if other procedures are needed.

The new donated meniscus is stitched into place to allow healing and fixation in position between the joint surfaces to replace the cushioning and protective effect of your original meniscus.

After the operation, there is a strict rehabilitation (physio) program. It is very important that this is followed to optimise the results.

IMPORTANT INFORMATION CONCERNING DONATED TISSUE: It is important to understand that the meniscus is tissue taken from dead tissue donors who have consented to their tissue being used. The donor is screened for systemic infections and the tissue that is donated is separately screened for infections and undergoes appropriate sterilization methods. Infection as a result of contaminated donated tissue is extremely rare. Medical treatment is not required for ‘stopping rejection’ as the donated tissue does not cause the same cross reaction that tissue such as kidney transplants cause. The graft is size matched to exact knee dimensions. It is very important the fit is as close as possible but this means a potential delay in finding a suitable match.