Meniscus Allograft Replacement Surgery: A minimally invasive method to restore previously removed torn knee cartilage with cadaver tissue
Edited By: John R. Green III, M.D.
Last updated Thursday, January 05, 2006
Review of the conditionCharacteristics of meniscus tear A torn meniscus generally produces pain in the region of the tear and
swelling in the knee joint. These symptoms are made worse with pivoting
motions, squatting, and vigorous activities. Torn meniscus fragments
can get caught in the knee joint and cause catching sensations. If a
large enough fragment becomes lodged between the bearing surfaces, the
knee may ‘lock’ and become unable to be fully bent or extended. Since
most meniscus tears are not repairable, they require removal of
meniscus tissue (meniscectomy). The loss of meniscus cushioning
overloads the articular (gliding surface) cartilage leading to the
development of arthritis over the ensuing decades. A few patients
experience pain in the region of the removed cartilage prior to the
development of arthritic changes. This small group may benefit from
allograft meniscus surgery.Types Meniscus tears are described by the tear pattern. Tears occur in either
the horizontal or vertical direction, or a combination of both.
Although the goal of meniscus surgery is to preserve healthy meniscus
tissue, many types of tears are not repairable. A meniscus tear
requires a blood supply to heal, and since only the peripheral third of
the meniscus has it, repairs are generally limited to the peripheral
region. Please see arthroscopic meniscectomy, and arthroscopic meniscus
repair for more information.Similar conditions Injuries to the articular (gliding surface) cartilage can also cause
pain, swelling and catching symptoms in the knee. An experienced
surgeon can often distinguish between the two conditions with a
thorough history and physical exam, but MRI can be useful as well.
These two conditions can occur together and are most accurately
diagnosed by arthroscopy. Please see articular cartilage injuries for
more information.Incidence and risk factors Meniscus tears are common in active participants of sports, which
require cutting and pivoting. In the United States, there are an
estimated 850,000 meniscus surgeries performed each year, the vast
majority being meniscus removal (meniscectomy) operations. The meniscus
on the side closest to the other knee (medial) is torn more frequently,
and men injure their meniscus more often than women.Diagnosis A torn meniscus is diagnosed with a thorough history and physical exam.
Traumatic meniscus tears often occur with twisting type or
hyper-flexion injuries. Physical exam maneuvers that reproduce these
symptoms may include squatting and rotational manipulations. MRI is
useful to confirm the diagnosis, but the most accurate test is
diagnostic arthroscopy. The short term results from menisectomy and
meniscus repair are good, but a few patients who have had significant
portions of their meniscus removed, develop pain in the local area.
X-rays are important to make sure that arthritis has not yet developed,
since meniscus replacement is not effective once advanced degenerative
changes are present.Medications Anti-inflammatory medications, taken by mouth or injected directly into
the knee, can be useful to reduce the pain and swelling symptoms
associated with meniscus tears, but do not improve healing. No
medications or nutritional supplements have been scientifically
documented as beneficial for meniscus healing.Exercises Quadriceps strengthening exercises are useful to reduce swelling and
restore normal muscular control to an injured knee. They useful to
reduce symptoms and speed rehabilitation.Possible benefits of allograft meniscus replacement surgery The meniscus is an important structure for load transmission and shock
absorption in the knee. The knee is subjected to up to 5 times body
weight during activity, and half this force is transmitted through the
meniscus with the knee straight, and 85% of the force goes through the
meniscus with the knee bent ninety degrees. Loss of the meniscus
increases the pressure on the articular (gliding) cartilage, which
eventually leads to degenerative changes. Pain may develop in the area
after a significant portion of the meniscus has been removed. A
successful meniscus replacement restores the cushioning meniscus
tissue, relieving this pain.Surgery for Meniscus Tear at the University of Washington If you are interested in making an appointment to discuss this procedure, you can request an appointment using our online referrals website. To request a referral online, please click here. You can also call 206-543-1552 to make an appointment.
How useful was this page or article?
|
|