Dr. Albert Pearsall, professor of orthopaedics and director of sports medicine at the University of South Alabama College of Medicine, said a torn meniscus is a common knee injury that is often seen in athletes. However, any activity that causes you to forcefully twist or rotate your knee, especially when putting pressure on it, can lead to a tear.
"The menisci are thick, load-bearing cartilage within the knee that are important in shock absorption and joint stability," he said. "They are c-shaped, attached to bone, and act to disperse the weight of the body and reduce friction during movement."
If you've torn your meniscus, you may experience the following signs and symptoms in your knee:
• A popping sensation
• Swelling or stiffness
• Pain, especially when twisting or rotating your knee
• Difficulty straightening your knee fully
• Feeling as if your knee were locked in place
Dr. Pearsall said there are different treatment options available for patients with a torn meniscus - including meniscal repair, debridement (taking the meniscus out), and meniscal transplantation (a procedure that transplants a cadaver meniscus into a patient’s knee).
Each knee has an inside (medial) and outside (lateral) meniscus. The lateral meniscus, unlike the medial meniscus, is not attached to a ligament. As a result, it is not torn quite as frequently.
In addition, the outer meniscus has blood supply, which is critical for healing. According to Dr. Pearsall, the outside meniscus will heal, but the inside usually will not heal.
“The medial meniscus is more of a problem,” he said, “and you often have to take it out because it just won’t last.”
When the meniscus is removed, the patient is left without much joint cushion. Over time, it can lead to arthritis in the knee joint and patients can develop pain where the meniscus was removed.
Dr. Pearsall said this is the point when a meniscal transplant may be a good treatment option. “This procedure helps prevent arthritis and provides stability,” he said. “It’s a way of trying to save the joints and cartilage in a patient who has had their meniscus removed.”
A meniscal transplant procedure involves the transplantation of a cadaver meniscus, harvested sterilely from a donor at time of death and preserved.
According to Dr. Pearsall, the ideal patient for a meniscal transplantation is someone under the age of 50 who has had their meniscus removed and who is having symptoms. Appropriate candidates for transplantation include non-obese patients with stable, well-aligned knees.
If you are a good candidate for a meniscus transplant, X-rays of your knee are usually taken to find a meniscus that will fit correctly into your knee. “They all have different sizes, shapes, configurations, and roles,” Dr. Pearsall said. “The meniscus has to match your size or it won’t fit."
Pre-operative planning for a meniscal transplantation involves a clinical evaluation to make sure the patient’s symptoms match what is seen on the X-ray, as well as an MRI to document that the meniscus is gone.
Dr. Pearsall said recovery time for a meniscal transplant is approximately three to six months before the patient is cleared for unlimited activities.
“Meniscal transplantation is a technically demanding procedure, but can be a very effective treatment in selected patients,” Dr. Pearsall said.
Dr. Pearsall recently gave an overview of cadaver cartilage transplantation at the September Med School Café lecture. To view the lecture in its entirety, click here.
To make an appointment with Dr. Pearsall, call (251) 665-8200.
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