Meniscal transplant in patients age 50 and under relieves pain, delays additional surgery
Most patients younger than age 50 with a torn or severely damaged meniscus experienced reduced pain and improved knee function following transplant surgery, according to a study in the August 5 issue of the Journal of Bone and Joint Surgery (JBJS). However, many patients required additional surgery within 10 years.
The meniscus is a wedge-shaped piece of fibrocartilage in the knee that acts as a shock absorber between the thighbone and shinbone. A meniscus can be torn during sports or wear away over time as the body ages. For younger patients with knee pain after loss of the meniscus, a meniscus transplant is performed to maintain a cushion between the two bones, stabilize the joint, prevent persistent knee pain, and to allow for greater mobility. An orthopaedic surgeon executes the knee surgery by using an arthroscope to accurately place and stitch new, transplanted meniscal tissue.
Researchers followed 38 meniscal transplant patients under age 50, who did not have arthritis, for an average of 11 years following surgery. Patient outcomes were evaluated based on clinical, subjective, and radiographic measures.
Sixty-three percent of meniscal transplants were viable at 10 years. Only 11 percent of patients with successful transplants had pain when engaging in daily activities. Also, nearly three-fourths of patients (72 percent) were able to take part in low-impact sports such as bicycling and swimming. In patients who required additional surgery, the meniscal transplants lasted between 7 and 8 years after surgery, depending on which side of the knee the meniscus transplant was located.
"This data provides surgeons with reasonable percentages that encourage delaying additional major knee surgeries related to a damaged meniscus," said Frank R. Noyes, MD, lead study author and founder of the Noyes Knee Institute at the Cincinnati Sports Medicine & Orthopaedic Center.
"However, the longer-term function of meniscus transplants remains questionable because the survivorship rate of the transplants decreases to between 40 and 15 percent at 15 years," said Dr. Noyes. "Patients should be advised that this procedure is not curative in the long-term and additional surgery will most likely be necessary."