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| Meniscus Injuries |
| The meniscus is the small shock-absorbing pad which protects the articular cartilage and assists in joint stabilization. Meniscus injuries can cause symptoms such as locking, catching, pain and swelling. Treatment depends on patient symptoms and the location of the tear. |
| Preserving the Meniscus |
| The goal of the WNYCRC is to maintain normal anatomy. In the case of meniscal tears, the first line treatment is an attempt at repair. Historically, in the days of open meniscus surgery, the entire meniscus was removed. With the advent of arthroscopy, standard treatment evolved to remove only the damaged area. |
| Unfortunately, long term follow up studies of these patients have found that many go on to develop degenerative arthritis. Today, cartilage surgeons recognize the protective value of the meniscal cartilage and make every effort to preserve this valuable tissue. |
| Restoring the Meniscus |
| To maintain the meniscal function following a tear, surgeons may repair the meniscus using a variety of techniques. Repair is performed arthroscopically using special sutures or absorbable implants to secure the tear. Only tears located in the periphery of the meniscus where there is a good blood supply for healing are amenable to repair. |
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| Even with the newest techniques available, certain tears are not repairable due to the location and pattern of the tear. A partial menisectomy with removal of only the torn cartilage is then performed. The remainder of the meniscus is preserved to maintain its function. |
| Meniscus Transplantation - Replacing the Meniscus |
| For patients who have had the meniscus removed from a prior surgery, the WNYCRC offers an innovative solution called a meniscal transplant. It is important to remember that even though only a part of the meniscus was removed, at times the effect on the knee from a biomechanical standpoint is the same as a total menisectomy. |
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| This procedure is indicated for younger patients who have not yet developed significant arthritis. Unlike other forms of tissue transplantation, this procedure does not require patients to be on medications to prevent rejection. Using this technique, a donated meniscus (tested for transmittable diseases) is transplanted under arthroscopic guidance to fulfill the role of the native meniscus and delay the progression to arthritis. Intermediate term follow-up studies in the literature are encouraging. |
| Future Trends |
| Investigators are now examining the potential of using collagen or another biological tissue to serve as a bridge or scaffold for the body’s own healing/repair mechanism to use in re-establishing meniscal form and function. The long term goal is to prevent the development or progression of arthritis. Through this effort, it is hoped that it may be possible to eliminate or decrease the need for later surgeries such as a total knee replacement. |
