First meniscal transplant at Whiston hospital was successfully performed by Mr. Attar
The first meniscal transplant at Whiston hospital using a donor allograft was successfully performed by Mr. Attar in a symptomatic patient who had had a previous medial sub total menisectomy. The operation which was performed in combination with a high tibial osteotomy went to plan and the patient was recovering well following surgery.
Meniscal surgery is the most commonly performed orthopaedic operation today. Partial menisectomies is by far the procedure of choice in meniscal tears and meniscal lesions as only a small percentage can be successfully repaired.
Patients, who have previously undergone partial or total menisectomies, are known to suffer with subsequent knee problems associated with degenerative changes in the knee. As the protective mechanism of the meniscus is lost, following menisectomies, contact forces through the cartilage can increase by up to 350% and this predisposes to wearing out of the cartilage and hence degenerative changes and pain in the knee. The association between osteoarthritis and menisectomy is well established and recognised now.
There are very few options available to efficiently manage this cohort of symptomatic patients until the degenerative process gets severe enough to warrant a total or partial joint replacement. In a young active patient, this is not an ideal treatment option.
Meniscal transplantation represents a potential biological treatment option for this specific cohort of symptomatic, meniscus deficient patients who have not yet developed advanced osteoarthritis. This is performed by using either a meniscal allograft or a synthetic scaffold and both, the medial or the lateral menisci can be transplanted if required.
Potential benefits include; advantage of recreating the meniscal function of load bearing, increasing joint congruency and reinforcing its function as a secondary stabiliser, theoretical protective effects on articular cartilage in the long term and advantage of delaying a joint replacement procedure.
On the basis of the satisfying clinical and radiological results, meniscal transplant surgery is a feasible, safe and reliable procedure to treat meniscus deficient pain in the specific symptomatic cohort of patients described.