Meniscus Allograft Transplantation FAQ

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What is a Meniscus?
The meniscus is the soft, fibrous shock absorber that rests in the knee between the femur and the tibia. When it is removed, pain and arthritis can develop.

What is Meniscus Allograft Transplantation?
Meniscus allograft transplantation involves taking a meniscus from a cadaver (some one who has just died). The meniscus is tested to ensure that it is not contaminated and then frozen. When all of the tests are negative for contamination, it is provided to surgeons for meniscus transplantation. The technique of transplantation involves an arthroscopic outpatient surgery (www.stoneclinic.com/menre.htm).

How Long Has Meniscus Allograft Replacement Been in Use?
Meniscus allograft transplantation was first performed in humans at the turn of the century, but the cases by Milachowski in 1986 stimulated renewed interest in the field. The meniscus allograft transplantation procedure was first performed by Kevin R. Stone, M.D. at The Stone Clinic in San Francisco in 1997.

Who Can Benefit?
Patients with joint pain after having previously lost their meniscus cartilage are our most common candidates. In older people, we place a meniscus in order to diminish pain and to delay the time when a partial or complete joint replacement would be required. In young people who have lost the cartilage usually due to sports, we place a meniscus to protect their joint for the future.

What are the Success Rates and the Problems?
Success rates are highest in the youngest patients with the healthiest joints of course. However, pain can also be diminished in older patients with arthritis. Exact survival data for our patients with the meniscus transplants is currently being evaluated and is posted at http://www.stoneclinic.com/meniscus_latest.htm. The most common problem has been partial re-tearing of the transplanted meniscus which has required surgical suturing (repair), and rarely, complete replacement. Rejection of the meniscus has not been seen in our patients and only reported worldwide in a few cases.

Can Infection from the Allograft Occur?
Yes it can despite all testing. We secondarily sterilize our grafts with alcohol at the time of surgery. However, a rare virus or bacteria could potentially survive.

What is the Recovery Time and Rehabilitation Program?

Partial weight-bearing status for 4 weeks

Most patients will be in a hinged rehab brace locked in full extension for 4 weeks

No resisted leg extension machines (isotonic or isokinetic).

No high impact or cutting/twisting activities for at least 4 months post-op.

Related Publications:
1. “Meniscus Allograft Survival in Patients with Moderate to Severe Unicompartmental Arthritis: A 2- to 7-Year Follow-up.” Stone KR, Walgenbach AW, Turek TJ, Freyer A, Hill M. Arthroscopy: The Journal of Arthroscopic and Related Surgery, Vol 22, No 5 (May), 2006: pp 469-478.
2. “Meniscal Allografting: The Three-Tunnel Technique.” Stone KR, Walgenbach AW. Arthroscopy: The Journal of Arthroscopic and Related Surgery, April 2003.
3. "Current and Future Directions for Meniscus Repair and Replacement." Stone KR. Clinical Orthopaedics, 367:S273-280, October 1999.
4. "Meniscus Replacement." Stone KR. Clinics in Sports Medicine, Vol. 15, No 3, pg. 557-571, July 1996.
5. "Replacement of the Irreparably Injured Meniscus." Rodkey WG, Stone KR, Steadman JR. Sports Medicine and Arthroscopy Review, Vol. 1, No. 2, pg. 168-176, 1993.
6. "Surgical Technique of Meniscal Replacement." Stone KR. Arthroscopy: The Journal of Arthroscopic & Related Surgery, Vol 9, pg. 234-237, April 1993.