Meniscus Transplant

Procedures

Meniscus Transplant

Overview

Meniscus transplant, or meniscal allograft transplantation (MAT), is a salvage procedure for patients who have lost a significant portion of their meniscus due to prior meniscectomy and are experiencing persistent knee pain or early joint degeneration. The procedure involves implanting a donor meniscus to restore shock absorption and improve knee function. Meniscus transplant is not a lifelong solution but is intended to provide a functional meniscus for approximately a decade, delaying the need for more invasive procedures such as knee replacement.

Patient Selection and Prerequisites

Successful meniscus transplantation requires a careful evaluation of knee alignment, cartilage status, and ligament stability:

  • Normal Alignment: The knee must have proper mechanical alignment to prevent excessive stress on the new meniscus.

  • Correction of Malalignment: If alignment is abnormal, it must be corrected first with a high tibial osteotomy (HTO) for varus alignment or a distal femoral osteotomy (DFO) for valgus alignment before proceeding with transplantation.

  • Intact Articular Cartilage: Patients must have relatively healthy cartilage on the femur and tibia, as meniscus transplant does not work well in the setting of advanced arthritis.

The Procedure

Meniscus transplant is performed arthroscopically and involves:

  1. Sizing the allograft to match the patient’s native meniscus.

  2. Preparing the knee by clearing scar tissue and ensuring the joint is properly aligned.

  3. Fixing the allograft into place using sutures and bone plugs to secure it to the tibia.

Recovery Process

  • Initial Phase (0-6 Weeks): Non-weight-bearing or limited weight-bearing with a brace to protect the transplant.

  • Intermediate Phase (6-12 Weeks): Gradual return to weight-bearing and physical therapy focused on mobility and strengthening.

  • Advanced Phase (3-6 Months): Continued rehabilitation with low-impact activity; return to sports and higher-impact activities is typically not recommended.

Risks and Considerations

  • Graft failure or re-tear over time, with longevity typically around 10 years.

  • Progressive joint degeneration if cartilage wear progresses despite transplantation.

  • Limited indications: Not suitable for patients with significant arthritis or severe instability unless addressed with additional procedures.

Conclusion

Meniscus transplant is a viable option for patients who have lost their meniscus and are experiencing pain and dysfunction. While not a permanent solution, it can help preserve knee function for about a decade before more invasive procedures become necessary. If you have had a prior meniscectomy and are struggling with ongoing knee pain, contact our office for a comprehensive evaluation and personalized treatment plan.