AANA/ISAKOS Knee and Shoulder Arthroscopy Course-Online Didactics (April 2024)-Meniscus Transplantation

Meniscus Transplantation_ Indications, Techniques, and Outcomes

Video Transcription

Video Summary

John Richman from Boston discusses meniscal allograft transplantation as a treatment for symptomatic knees after major meniscal resection. Historically, total meniscectomy was standard, but recognition of its relation to joint degeneration shifted focus to meniscal preservation. Indications for transplantation include joint line pain following substantial meniscectomy, ideally in young patients with stable, well-aligned knees and minimal cartilage damage. Preoperative arthroscopy is favored over MRI alone for assessment. Surgical technique involves careful preparation of the meniscal rim and bony fixation using bone plugs medially and bone bridges laterally to reduce extrusion. Postoperative care includes initial non-weight-bearing with gradual rehabilitation, and patients are advised to avoid high-impact activities. Outcomes show a high rate of healing and pain relief, with many grafts lasting over 10 years, although cellular differences suggest allografts may eventually fail. Results decline in older patients, and transplantation is not recommended for osteoarthritis alone. Overall, meniscal transplantation is a valuable option for selected patients after meniscectomy.

Keywords

meniscal allograft transplantation

meniscectomy

joint line pain

meniscal preservation

surgical technique

postoperative rehabilitation