Re: Info on Meniscus Transplants

Posted By: SueBW <sbwestin@csmref.org>

Date: Wednesday, 7 January 2004, at 4:38 p.m.

In Response To: acl revision via allograft + menisectomy (A.U.)

I am sorry to hear of your knee condition at such a young (yes, I consider 35 young) age. However, you are not alone. And, unlike your surgeon stated, meniscus transplantation is not a new or experimental operation.

Meniscus allografts have been performed in the U.S. since at least 1988. There have been many articles published in the literature over the last 10 years which document the outcome of this operation (I can provide references if you are interested). Basically, this operation is indicated in patients who have had all of the meniscus removed, have sufficient joint space remaining between the femur and tibia, do not have significant arthritic damage, are under the age of 50, and have normal lower limb alignment and a stable knee. If the lower limb is in varus (bow leg), then a corrective osteotomy must be done first. And, if the knee is unstable via ACL-deficiency, then a ligament reconstruction must be done (with normal stability restored).

You may very well be a candidate for this operation. Be aware, however, that the main goal is to provide additional years to your knee joint before a uni- or total knee replacement is required. Most patients who have this operation are advised to return to light low impact sports to preserve the knee joint for as long as possible. You don't want to be looking at a knee replacement at the age of 45! Therefore, a return to an active lifestyle is possible, but realistically, this involves bicycling, swimming, low impact aerobics, light hiking, and the like. There are some patients who have returned to sports like tennis successfully. And, there are patients who are 10 years out from the transplant doing well.

The long-term results are still unknown, but in my opinion, this provides at least the opportunity to protect the joint - what are the other options? If you remain active with a completely meniscectomized knee (especially with the activities you mention), then chances are good that you will suffer arthritic symptoms fairly rapidly. These symptoms include pain and swelling with normal daily activities, like simple walking. Unfortunately, in many patients by the time this occurs the joint has deteriorated too severely for a meniscus transplant to be implanted.

Good luck in your recovery,

SueBW