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Meniscus transplantation in an active population with moderate to severe cartilage damage

Kevin R. Stone · Jonathan R. Pelsis · Scott T. Surrette · Ann W. Walgenbach · Thomas J. Turek 

A long-term study of 49 meniscus transplant patients found that athletes who replace their damaged or missing meniscus with donor tissue can recover well enough to get back to sports, for up to 15 years, even if they had already developed osteoarthritis.

The study was carried out by the Stone Research Foundation in San Francisco and published on September 26, 2014 in the journal of Knee Surgery, Sports Traumatology, Arthroscopy.

Study Highlights

  • 49 highly active patients were followed for up to 15 years following their surgery, with an average follow up time of 8.6 years
  • 38 (78%) patients reported sustained improvements in pain, function and activity levels up to 15 years after their meniscus transplantation
  • 11 (22%) received an average of 5.2 years of benefit before requiring alternative treatment such as knee replacement
  • 36 (75%) patients participated in sports post-surgery

The study estimates that, on average, patients will benefit from this procedure for 12.6 years before requiring alternative treatment such as knee replacement

What’s new?

Previous studies have found that meniscus transplants can reduce pain and improve function for patients with missing or irreparable meniscus tears. Until now there has been little information on how the procedure works for patients who also have severe articular cartilage damage (osteoarthritis, OA) and want to participate in sporting activities. This study challenges current medical thinking that it’s not advisable to have a meniscus transplant if you have arthritis, and that it's definitely not possible to return to sports.

About the study

The study included 49 patients from The Stone Clinic who had a badly damaged meniscus and severe cartilage damage and needed a meniscus transplant, typically the toughest patients to treat. Prior to their injury, all 49 patients had participated competitively in highly active sports such as soccer, football, rugby, ice hockey, wrestling, squash, badminton, track and field, or downhill skiing. Each patient also expressed a desire to get back to sport after his or her surgery.

All 49 patients had a meniscus replacement. 41 patients had a procedure to repair the damage to their articular cartilage.

After their procedure, the patients followed a rigorous rehabilitation program beginning the day after surgery. They were contacted for follow up at regular intervals over an average period of 8.6 years. Each patient was asked if they were still enjoying function improvements and pain relief from the meniscus transplant and then asked to complete a questionnaire on the status of their knee.

Conclusions

Meniscus transplantation is a viable surgical option for patients with severe cartilage damage and missing or irreparable menisci.  It provides significant improvement in pain and function levels in the medium to long-term with the majority of patients achieving their goal of participation in sporting activities.

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Stone, K.R., A.W. Walgenbach, A. Freyer, T.J. Turek, and D.P. Speer. 2006.