Meniscal Transplantation

The meniscus in your knee works as a washer or spacer. It is wedge shaped in cross section and a crescent when seen from above. There are two menisci in each knee (medial meniscus and lateral meniscus)

The menisci are sometimes damaged, for example in sports injuries such as playing football. Tears to a meniscus can be dealt with by trimming or stitching via arthroscopic (keyhole) surgery. The aim of such surgery is to preserve the meniscus. However if the meniscus very badly damaged, it may need to be removed. In the past, removing the whole meniscus was done more frequently. However it has since been found that this is not a such a good treatment removing the whole meniscus often leads to premature arthritis.

One way of treating knees where there is little or no meniscus left is by performing a meniscal transplant. This technique uses a meniscus from a donor. The tissue is donated in a similar way to other organs for transplantation (eg kidney, heart, lung, etc.) There is a difference as compared to other organ transplants in that tissue matching is not needed. This is because the meniscal transplant is not a living tissue, (like a kidney transplant) but a piece of protein, (a bit like a piece of gristle) which is relatively inert.

Meniscal transplants are usually frozen which inactivates any living cells. They are carefully screened for transmissible diseases. Like most organ transplants, tissue is in short supply and there may be a considerable wait until a meniscus is available.

The transplant can be done as either an open or arthroscopic procedure, and may be done in conjunction to other techniques such as Autologous Chondrocyte Implantation or osteotomy.