Meniscus Transplant

A good candidate for meniscus transplantation is typically a young, active individual who has had a previous meniscectomy (meniscus removal) and is now experiencing persistent knee pain. Ideally, the candidate should not have advanced arthritis in the knee and should have a stable, well-aligned knee joint.

Meniscus transplant surgery is performed arthroscopically, along with minimally invasive surgery techniques. First, the meniscus from a deceased donor is prepared to fit the size and shape of your knee. This meniscus is carefully selected based on the patient’s size and imaging to ensure it is a good match for the size and shape of their knee. Then, using small incisions, a tiny camera (arthroscope) is inserted to visualize the knee joint. Tiny instruments are used to prepare the knee for the graft, which involves cleaning the torn tissues out and creating tiny holes for the new meniscus to be attached. Then, the donor meniscus is inserted and secured into the knee using sutures.

Recovery from a meniscus transplant is a gradual process. Generally, patients can expect to return to light activities or desk jobs within a few weeks post-surgery. However, the full recovery timeline, including return to sports, is typically between six months to a year. This is to allow the transplanted meniscus to heal properly and become integrated into the knee.

After the surgery, you’ll likely stay in the recovery room for a few hours while the anesthesia wears off and you are allowed to go home. Your knee will be bandaged and will be placed in a brace. Crutches will be needed to avoid putting weight on the operated knee for several weeks. Pain medications will be prescribed to help manage post-operative discomfort.

Rehabilitation following a meniscus transplant is crucial for a successful outcome. It generally involves three phases:

• Early Stage (Weeks 1-6): Initial goals are to decrease swelling, protect the graft, and gradually restore knee range of motion. Weight-bearing is gradually increased.
• Middle Stage (Weeks 6-16): Focus on improving strength and balance, and restoring full range of motion. Low impact activities like cycling may be introduced.
• Late Stage (Weeks 16 and beyond): Gradual return to daily activities and sport-specific exercises, as directed by your physical therapist and surgeon.

Every surgical procedure carries some risks. For meniscus transplant, these include:

• Infection: Occurs in less than 1% of patients. Antibiotics are given during surgery to minimize this risk.
• Blood clots: Deep vein thrombosis (DVT) or pulmonary embolism (PE) can occur but are very rare (less than 1%). You will be given aspirin to take every day for one month to minimize this risk.
• Graft failure: The transplant meniscus may not heal properly, resulting in continued knee problems. This occurs in approximately 5-10% of cases.
• Stiffness or loss of motion: Some patients may experience stiffness or a loss of motion in the knee.
• Nerve or blood vessel damage: Very rare but can lead to numbness or weakness in the leg.

If it is recommended to undergo a meniscus transplant and you choose not to have surgery, there are potential risks:

• Persistent knee pain: Without a functioning meniscus, you may continue to experience persistent knee pain.
• Further knee damage: The absence of a meniscus can lead to further wear and tear on the knee joint, potentially causing early onset of osteoarthritis.
• Limited function: Without the shock-absorbing function of the meniscus, you may have difficulty returning to your usual level of physical activity, including sports or physically demanding work.