As life happens, so do injuries, especially those that occur when we least expect them. Sometimes these injuries need special care and attention. A torn meniscus in the knee, for example, whether the result of a quick pivot during a basketball game, an unexpected fall or just wear and tear over time, can have long-lasting effects. Like a lot of knee injuries, a meniscus tear can be painful and debilitating. Living without a meniscus can increase the risk of osteoarthritis and chronic knee pain. A meniscal transplant may be the answer. The best way to find out is to question the skilled and experienced orthopedic specialists at OCC – Advanced Orthopedic & Sports Medicine Specialists in Denver, Parker, or Aurora, Colorado. A meniscal transplant can allow young, active people to return to daily activities and can even help injured athletes return to their sport.
OVERVIEW
Meniscus tears are among the most common knee injuries affecting approximately 1 million people in the U.S. each year. They are one of the most frequently occurring cartilage injuries of the knee. When people talk about “torn cartilage” in the knee, they are usually referring to a torn meniscus. However, meniscal transplant surgery is rare and not for everyone. In a meniscus transplantation, a surgeon implants a new meniscus (taken from a cadaver) into the patient’s knee joint. This procedure is technically known as meniscal allograft transplantation (MAT). Allograft is a term that simply means “the transplantation of tissue from one person (a donor) to another”.
ABOUT THE MENISCUS
Three bones meet to form your knee joint: your thighbone (femur), shinbone (tibia), and kneecap (patella). A meniscus is a C-shaped wedge of rubbery cartilage that sits in the knee joint between the ends of the tibia (shinbone) and femur (thighbone). It is considered the knee’s main shock absorber. Each knee contains a medial (inner) and lateral (outer) meniscus, which together are called menisci (the plural of meniscus). The medial meniscus, on the inside of the knee, absorbs about 50% of impact to the knee joint – thus, it helps to prevent osteoarthritis, especially in somebody who is bowlegged (varus alignment). The role of the medial meniscus is also important in patients who are missing an anterior cruciate ligament (ACL) or who have previously received an ACL reconstruction. The posterior horn of the medial meniscus serves as a backup to the anterior sliding of the knee, which can cause an ACL reconstruction to fail if the meniscus is not present to act as a bumper. The lateral meniscus absorbs more shock than the medial meniscus. The lateral meniscus has been noted to absorb about 70% of the impact on the lateral compartment in the knee. In addition to shock absorption, the lateral meniscus also plays a key role in the protection of an ACL reconstruction and provides stability in the presence of a torn ACL. In the absence of an ACL and lateral meniscus – there is a significant amount of rotational instability.
WHAT IS A MENISCAL TRANSPLANT?
A meniscal transplant is a surgery to replace a damaged, torn, or missing meniscus. Surgeons usually perform this procedure on people under age 40 or 50 who are physically active and maintain a healthy weight. To be eligible for a meniscal transplant, there must be a missing part of the meniscus or it has a severe tear. Other parts of the knee should not have damage. If there is already arthritis present, and the cartilage in the knee has worn away too much, the procedure might not be successful. This is why for many older patients with this condition, a total or partial joint replacement might be the right option. Allograft tissue for a meniscal transplant (meniscal allograft transplantation – MAT) comes from a human donor, in this case, a cadaver (deceased donor). For allograft preparation, healthy cartilage tissue is taken from the cadaver and frozen. A screening process is done before selecting a possible donor. Someone who knows the donor well is interviewed to help identify risk factors that would prevent the use of the donor tissue. Once selected, the donor tissue undergoes many tests. The safety of the tissue is monitored by the American Association of Tissue Banks and the United States Food and Drug Administration. The tissue is tested for viruses like those that cause HIV/AIDS, West Nile virus, hepatitis B and C, as well as for bacteria. A meniscal transplant is not like a heart or lung transplant, in which “rejection” can occur. Additionally, patients do not need to be on immunosuppressants or other medications after the procedure.
Read more about Meniscus Transplants on our new Orthopedic News Site – Colorado Orthopedic News. Schedule an appointment with a knee specialist today.
