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I had to have the meniscus removed from my left knee due to severe damage. I've been told about the dangers of arthritis developing. Can anything be done to prevent this?

The meniscus is one of two types of cartilage in the knee that helps stabilize, protect, and improve knee function. The second type of cartilage is called articular cartilage. The articular cartilage is right next to the joint surface. It provides a smooth surface for movement of the bones against each other. The meniscus is next to the articular cartilage between the femur (thigh bone) and the tibia (lower leg bone). These two bones connect together to form the knee joint. The menisci support the knee joint, help distribute and transfer the load, and provide nutrition and lubrication to the joint. Without it, the concentration of force into a small area on the articular cartilage can damage the joint surface. Research clearly shows early osteoarthritis from joint degeneration is to be expected. There are different ways to approach the treatment (and prevention) of this type of joint degeneration after meniscectomy. One of those has been around for the last 25 years: the allograft meniscal transplantation. Allograft means the patient is receiving meniscal tissue donated by someone else (after death). The menisci are harvested and preserved by freezing them until needed. The patient receiving the graft is carefully tissue-typed to find a match with donor (allograft) tissue. Not everyone can have this procedure. Research shows results are best when it is used for younger adults (less than 50 years old) who have an intact anterior cruciate ligament (ACL). The ACL is needed for good support and stability. Without a healthy ACL, the meniscus is subject to even higher demands. The allograft is more likely to detach and fail when the knee is unstable because of a deficient ACL. The ACL should be repaired first before doing the allograft. Normal knee alignment is necessary for a good result. The allograft is done when meniscectomy patients develop painful and limiting unicompartmental arthritis (affecting one side of the joint). There is some evidence to suggest the earlier this procedure is done, the lower the failure rate. But timing is important because they don't last forever. Talk with your orthopedic surgeon about your options. He or she may have some ideas about what might work best for you. A strengthening program for the muscles around your knee is a good idea to help support and protect the joint. Improving kinematics (how the knee moves) and proprioception (the joint's sense of position) may help prevent uneven or unnecessary wear and tear. A physical therapist can help you find the right program of exercise for strength, flexibility, and function.

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