Problems and Pitfalls of Meniscal Transplant

In this report, well-known surgeons in sports medicine present results of a study on knee meniscus transplants. A step-by-step description is given for several meniscal repair operations. Possible problems and pitfalls are mentioned.

Special instructions are given for meniscal transplant on the inside or outside edge of the knee joint. The authors include how surgeons test the patient's knee while still in the operating room.

Results of the study are detailed and cover a wide range of measures. For example, some results are given based on the condition of each patient's knee (mild to severe changes). The patient's level of activity is reviewed before and after the operation. X-ray findings and MRI results are described before and after the operation. Problems after surgery are also discussed.

All 40 patients in this study were less than 50 years old. All had a meniscal transplant. About 40 percent of the patients had a second operation at the same time. This second operation was a bone transfer called osteochondral autograft transfer. It's used when the meniscus is damaged so badly that the bone underneath is showing.

The authors say this is the first report about the outcomes of these two operations together. Success and failure rates are reported. Eleven of the 40 total transplants failed. This is about 30 percent of the total group.

The authors conclude that meniscal transplants often tear or fall apart after being put into the knee joint. It's still a good option for young patients with severe joint damage and no other choices. Treatment is advised as early as possible before more joint damage occurs.



References: Frank R. Noyes, MD, et al. Meniscal Transplantation in Symptomatic Patients Less Than Fifty Years Old. In The Journal of Bone and Joint Surgery. July 2004. Vol. 86. No. 7. Pp. 1392-1404.