Meniscus replacement

Meniscus transplant (allograft) with bone plugs.

A Meniscus transplant (alograft) with donor bone block.

Replacing a destroyed knee meniscus

Once a meniscus has been removed in a total meniscectomy procedure, a patient is still able to cope and even return to sport.

However, that shock absorption within the joint - previously provided by the original meniscus - will have been lost and the forces through the knee will have been changed.

The patient may notice that the knee thrusts outwards with each step. Over the years it is likely that the knee may start to bow (varus deformity), and arthritis may develop and cause pain. So younger or still active patients may seek to have some kind of meniscus replacement to help the knee to last longer without these complications.

Past attempts to reconstruct a functional 'meniscus' from the patients own tissues (such as ligament) have largely been unsuccessful, and today meniscus replacement tends to involve -

• a meniscus transplant from a donor (meniscal allograft), or
• an artificial spacer (collagen meniscal implant/collagen scaffold)

• Quote from peer-reviewed paper:

  "....the techniques of meniscal allograft transplantation evolved to become the current standard-of-care for total meniscal insufficiency...."

  Citation: Winkler PW, Rothrauff BB, Buerba RA, Shah N, Zaffagnini S, Alexander P, Musahl V. Meniscal substitution, a developing and long-awaited demand. J Exp Orthop. 2020 Jul 25;7(1):55. doi: 10.1186/s40634-020-00270-6. PMID: 32712722; PMCID: PMC7382673.

• Quote from peer-reviewed paper:

  "....Increasing clinical evidence for the efficacy of artificial scaffold-based meniscal substitutes has emerged for the treatment of irreparable partial meniscal injuries...."

  Citation: Winkler PW, Rothrauff BB, Buerba RA, Shah N, Zaffagnini S, Alexander P, Musahl V. Meniscal substitution, a developing and long-awaited demand. J Exp Orthop. 2020 Jul 25;7(1):55. doi: 10.1186/s40634-020-00270-6. PMID: 32712722; PMCID: PMC7382673.

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Osteotomy to relieve symptoms after meniscus removal

A further option to improve knee function when a meniscus has been removed is 'osteotomy', where a wedge in the bone of the tibia or/and femur allows the alignment of the limb to be improved.

This may be in addition to the replacement procedure, or in place of it.

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Forum discussions

• MENISCUS TRANSPLANT - SOCCER/FOOTBALL

  PA long discussion between patients.

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