How Are Meniscus Transplants Performed?

When meniscus tears occur, physicians will assess the damage to determine if the cartilage can be repaired, trying to maintain as much of the original tissue as possible. However, if the meniscus is damaged beyond repair or its condition is highly deteriorated, physicians may recommend removing it altogether and substituting it with a transplant. 

Meniscus transplant is a safe and commonly performed procedure that is recommended for patients meeting the following standards:

• Are younger than 40
• Are motivated to undergo a lengthy rehabilitation program
• Have had previous interventions to remove damaged meniscal tissue
• Have ongoing pain that limits activities
• Have a proper or correctable limb alignment
• Have a body mass index lower than 30 (not obese)

The intervention is also known as meniscal allograft transplantation, meaning that the transplanted cartilage tissue is acquired from a donor that passed away. Notably, transplant rejection doesn't occur in this type of intervention, and patients won't require immunity suppressant medication. 

At the start of the intervention, patients are administered general, regional, or local anesthetics to prevent them from feeling discomfort. Operating physicians typically employ the minimally invasive arthroscopic method to perform meniscus transplants, making several tiny incisions around the knee. A small camera with a light source known as an arthroscope is inserted through one of the incisions to guide the surgery. 

After clearing the knee joint of any cartilaginous particulate, small tools are introduced through the other incisions to remove the remaining damaged meniscus. The donor tissue is then positioned and anchored in the shinbone using screws or plugs and connected to the knee joint capsule with the help of sutures. After the transplant is effectuated, the surgeon removes the instruments and closes the incisions, dresses the wound, and the operation is done.

Meniscus transplant surgery usually takes about 2 hours to complete but can last longer if additional interventions like ACL reconstructions are performed simultaneously. As an outpatient procedure, patients may be able to return home on the same day as their operation. However, because the original tissue has been replaced with donor cartilage, patients may be required to spend 1 - 2 nights in the hospital before returning home and focusing on recovery and rehabilitation.