The meniscus is a C-shaped piece of tough cartilage located in the knee, that acts as a shock absorber between the shinbone and the thighbone. There are two minisci within each knee. The meniscus on the inside part of the knee is known as the medial meniscus and the meniscus located on the outside of the knee is referred to as the lateral meniscus. A meniscus tear may be the result of an activity that forcefully twists or rotates the knee.
When a meniscus is torn due to injury or overuse, it can often be repaired with surgery that involves suturing the damaged ends together. However, in cases where the meniscus is extremely damaged and cannot be repaired, it may need to be removed completely and replaced with donor cartilage. This type of transplant can provide cushioning to the joint and prevent the bones and other structures from rubbing together, alleviating considerable pain.
Candidates for a Meniscal Transplant
A meniscal transplant is typically much more successful in a younger, active individual who has damage due to an injury. Candidates for a meniscal transplant may include individuals who:
- Have persistent pain
- Have a meniscus tear that cannot be repaired
- Have stable knees with normal alignment
- Do not have arthritis
- Are physically fit and not obese
Older patients, especially those with osteoarthritis, are often better candidates for a joint replacement surgery instead of a meniscal transplant.
The Meniscal Transplant Procedure
This meniscal transplant is commonly performed as an outpatient procedure. The meniscal transplant procedure is performed arthroscopically, with tiny surgical instruments inserted through very small incisions. The arthoscope is inserted into the knee through a small incision. The meniscus and any remaining tissue are removed from the knee. The donor meniscus is attached to the shinbone and sutured in place. The incision is then closed and bandages are placed over the wound.
Rehabilitation after Meniscal Transplant
After meniscal transplant surgery, a knee brace and crutches are required for approximately four to six weeks. This allows the transplanted meniscus and surrounding tissue to become fully attached to the bone while it heals. A physical therapy program is an important part of the rehabilitation process and will help patients regain flexibility, strength and motion in the knee joint. Without proper rehabilitation, complications such as chronic pain, inflammation and weakness, may cause difficulty walking and performing physical activities.
The injured knee is often treated with a removable brace, and patients are typically advised not to put any weight on the leg for several weeks. A physical therapist helps the patient to walk safely using crutches or other assistive device. Once the brace has been removed and patients can begin moving their leg, physical therapy and home exercise are extremely important for a full recovery. Physical therapy treatments may include:
- Muscle strengthening exercises
- Gradual weight-bearing activities
- Range of motion exercises
- Balance training
Depending on the patient's physical job requirements or athletic activities, a physical therapist may create a tailored treatment plan. Activities can slowly be introduced during the rehabilitation period, however, full recovery from a meniscal transplant may take 6 months to 1 year.