Meniscus Transplantation

Meniscus transplant surgery is the replacement of a surgically removed meniscus with a donor meniscus. This technically demanding procedure may be recommended for young, active patients, under age 40 with a BMI of 30 or below who have previously had their meniscus removed and develop knee pain that interferes with the activities of daily living.

Meniscus transplantation can restore natural knee biomechanics, relieve pain, improve knee stability and protect the knee cartilage to prevent or delay knee arthritis and future knee replacement surgery.

Meniscus transplantation is an established treatment and realistic option indicated in symptomatic meniscus-deficient patients with minimal to no arthritis. It is an integral part of knee preservation. Studies report that transplantation yields good long-term survivorship lasting between 10 -15 years.

A good candidate for meniscus transplantation typically meets several criteria, focusing on the individual’s age, activity level, overall knee health, and specific knee pathology. These criteria are important to determine whether the transplantation will be successful in relieving symptoms and restoring function.

1. Age and Activity Level: The procedure is often recommended for younger active patients, generally under the age of 40, who are too young for more invasive joint replacement and desire to return to an active lifestyle.
2. Previous Meniscectomy: Candidates have undergone a partial or total meniscectomy and have persistent symptoms that negatively affect their quality of life.
3. Symptoms: Symptoms include localized pain in the knee where the meniscus was removed, and significant functional limitations that impact daily activities and physical activities.
4. No or minimal osteoarthritis: Good candidates should have only a small, isolated area of cartilage loss.
5. Knee joint stability: The knee should be stable with no significant ligament laxity or instability because instability can jeopardize the success of the transplant.
6. Knee alignment: Candidates should have proper mechanical knee alignment. If necessary, corrective procedures can be considered in conjunction with the transplant.
7. Appropriate weight: Candidates must have a healthy weight (BMI under 30) to reduce stress on the joint and the transplant.
8. Commitment to rehabilitation: Candidates must be committed to a comprehensive and 8–10-month rehabilitation program to ensure the best outcome from the surgery.

Determining who is a good candidate for meniscus transplantation is a complex decision that involves a thorough evaluation by Dr. Ronak Patel. He will consider all these factors, along with imaging studies and possibly other diagnostic tests, to ensure that the patient is an ideal candidate for this procedure.

The surgery involves the transplantation of a donor meniscus (allograft) into the knee. The donor tissue is sourced from a tissue bank. It is sized, tested for disease and frozen. During surgery the transplant is carefully matched in size to the recipient’s knee. There is no risk of rejection from the transplant because it is acellular. The surgery is an arthroscopic procedure which involves small incisions and the use of a camera (arthroscope) to guide the procedure, and small surgical instruments. This is minimally invasive surgery. Any remaining meniscus tissue is cleaned out and the transplant is sized and sewn into place.

If other knee repair is necessary, such as an ACL reconstruction or the repair of articular cartilage, these repairs may also be performed during the transplant procedure.

Post-surgery, the knee is typically immobilized for a period to protect the graft. Weight-bearing on the operated leg is often restricted for around 6 weeks. Total recovery time can vary but generally spans several months to a year, depending on the individual’s healing response and the specifics of their case. Studies report that about 80-90% of athletes are able to return to their pre-injury level of activity.