Meniscal Transplant Surgery

What is meniscus transplant surgery?

Meniscus transplant surgery is a type of surgery that replaces your missing or damaged meniscus with a meniscus from a cadaver donor. The surgery usually takes place under general anesthesia.

Your knee has 2 wedge-shaped pieces of cartilage, 1 on each side of your knee. They lie on top of the shinbone (tibia). Each one of these pieces is called a meniscus. These 2 rubbery menisci act as shock absorbers between your thighbone (femur) and your shinbone (tibia). A different type of cartilage capping the tibia and femur also helps your bones move smoothly. These 2 menisci help protect the ends of your femur and tibia as they move together.

Sometimes, a twisting injury may severely damage your meniscus. If the damage is severe enough, your surgeon may need to remove your meniscus. Without this meniscus cushion, the ends of your tibia and femur may start to rub together abnormally. Over time, this can cause persistent knee pain. Eventually, it may cause arthritis. Your cartilage “cap” degrades and the bones beneath start to scrape together.

Meniscus transplant surgery provides another choice for you. Your surgeon makes a small incision in your knee. He or she uses special instruments and cameras to access the joint space between your femur and tibia. Next, your surgeon surgically sews the donated meniscus into your joint space.

Why might I need meniscus transplant surgery?

Meniscus transplant surgery might
make sense for you if your meniscus was removed in a previous surgery. (This probably
happened if the damage to your meniscus was so bad that surgeons couldn’t repair it in
that previous surgery.) Without a meniscus, you might gradually develop knee pain and
arthritis of your joint. Replacing your meniscus may provide significant pain relief. It
may also help prevent arthritis in your joint. This can develop when your cartilage
becomes frayed and rough. This surgery is less invasive than knee replacement
surgery.

Meniscus transplant surgery might
not make sense for you, even if you’ve had your meniscus removed. If you already have
arthritis of your knee, the procedure might not help because you may already have too
much damage to your cartilage and bone. Another procedure, like knee replacement, might
be more effective.

You might be a good candidate for
meniscus transplant surgery if the following apply to you:

  • You’re younger than age 55.
  • You’re missing more than half your meniscus, or you have a large meniscus tear that is irreparable.
  • You have significant or persistent pain with activity, or you have an unstable knee.
  • You have only minimal arthritis, or none at all.
  • You have a knee with normal alignment and stable ligaments.
  • You are not obese.

How do I get ready for a meniscus transplant surgery?

Talk with your healthcare provider
about how to prepare for your meniscus transplant surgery. Ask whether you should stop
taking any medicines ahead of time, like blood thinners. Tell your healthcare provider
about all the medicines you take, including over-the-counter medicines like aspirin.
You’ll need to avoid food and drink after the midnight before your procedure.

Before your procedure, you may need
other imaging tests, like X-rays and MRI.

You may need to rearrange your living arrangements as you recover because you’ll need to use crutches for several weeks.

You may be able to go home on the day of your surgery. It’s also possible you’ll need to stay in the hospital for a day or two. Talk with your healthcare provider ahead of time so that you can make the necessary arrangements for your recovery period.

Before your surgery, a healthcare provider will carefully screen the donated meniscus for any signs of infection.

What happens during meniscus transplant surgery?

Your healthcare provider can help
explain the details of your particular surgery. An orthopedic surgeon will do the
surgery. The whole operation may take a couple of hours. In general, you can expect the
following:

  • A healthcare provider (anesthesiologist) will give you medicine so that you’ll sleep through the operation and won’t feel any pain or discomfort during the surgery. (You may receive spinal anesthesia and a medicine to help you relax.)
  • Your vital signs, like your heart rate and blood pressure, will be monitored during the operation. You may have a breathing tube inserted down your throat during the operation to help you breathe.
  • After cleaning the affected area, your surgeon will make a small incision through the skin and muscle of your knee.
  • Your healthcare provider will insert a very small camera through this incision, using this camera to guide the surgery.
  • Using very small instruments inserted through the incision, your surgeon will remove any remaining meniscus.
  • Next, he or she will surgically sew the donated meniscus into the joint space. The healthcare provider might use screws or other devices to hold the meniscus in place.
  • Your surgeon will make other repairs,
    if needed.
  • The surgeon will close the layers of skin and muscle around your knee.
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