Orthopaedic & Rehab Center
Akron General offers alternative for relieving pain and restoring mobility
Accidents and sports injuries can tear the meniscus, a cushion inside the knee that serves as a shock absorber to help it bear weight, glide and turn. This tear can result in knee pain that does not disappear even when the meniscus is partially or totally removed.
An orthopaedic surgeon may be able to repair a damaged or torn meniscus. However, one that is badly damaged or has an extensive tear may have to be removed. Without this cushion, the knee joint can develop persistent pain, swelling and premature arthritis in an otherwise young and healthy person.
An alternative procedure
“For younger patients – those from their upper teens to their mid-40s – a procedure called meniscal transplantation can be an excellent alternative for relieving pain and restoring mobility,” says Akron General Orthopaedic Surgeon John Pinkowski, MD.
In this procedure, a meniscus selected from a bone bank (allograft) is inserted in the knee arthroscopically through several small “keyhole” incisions. Because the donated meniscus must be exactly the right size, X-rays and CT scans of the patient’s knee are taken to enable precise measurements to be determined. A match is then requested from a bone and soft tissue bank. Bone and soft tissue banks follow strict guidelines in obtaining and sterilizing allografts, and testing donors for bacteria, HIV, hepatitis, and other viral diseases, so disease transmission is rare.
The allograft meniscus is inserted in the knee and secured with sutures and bone plugs. After an overnight hospital stay, the patient goes home with a leg brace and no weight bearing with motion is allowed for several weeks. Rehabilitation is required to keep the knee flexible. By six months, healing is usually complete and patients may resume their normal activities, including sports.
Dr. Pinkowski adds that while a transplanted allograft can tear like any other meniscus, there are few problems associated with the transplant itself. And the risk of rejection is so low that immunosuppressive medications are not necessary.
Is it right for you?
Ideal candidates for meniscal transplantation are young, of normal weight, and without a knee deformity or significant arthritis. Approximately 85 percent of patients can expect good-to-excellent results with a dramatic reduction or elimination in pain and return to many normal activities.
Loss of a large section of meniscal cartilage can result in premature arthritis in an otherwise young and healthy person. These young patients with advanced arthritis are not ideal candidates for total knee joint replacement, because after a knee replacement reduces their pain, they resume an active lifestyle and wear out the knee replacement prematurely.
“Knee replacements are not advised for younger patients for the simple reason that they wear out before the patient is ready to slow down. This requires a second knee replacement, which may not be as successful as the first,” says Dr. Pinkowski.
Find out more
For more information on this and other state-of-the-art procedures and services through Akron General’s Orthopaedic & Rehab Center, call 330-344-AGMC (2462) or visit www.akrongeneral.org.
