Abstract
After meniscetomy there is an increased risk of tibiofemoral arthritis. In recent times there has been an increased emphasis on preservation of healthy meniscal tissue. When this cannot be achieved some patients may benefit from allograft transplantation. This aims to restore meniscal function and so limit pain and the development of arthritis. This is an evolving area with controversy surrounding patient selection, tissue harvesting and sterilisation, longterm outcome and overall efficacy.
Twenty-eight patients have undergone 30 meniscal transplants beginning in 2001. All transplants have been performed by the senior author. The mean age at surgery was 37.7 years (range 20–51), there were 16 males and 12 females. At the time of the index operation nine patients underwent additional procedures on the same knee. All patients are scored using recognised knee scoring systems including the Oxford, IKDC and Lysholm scores. All patients are being followed up regularly with clinical assessment and repeat scores.
To date the average follow up is 34.3 months (range 6–84). There have been 12 patients requiring further arthroscopy (three with complete meniscal transplant failure). The average increases in Lysholm, Oxford and IKDC scores were 10.7, 7.6 and 8.6 respectively.
Lack of donors is the current limitation to performing transplants in Brisbane. 61 patients are currently awaiting suitable menisci and in the last 12 months there have been only three donors. A national registry may address this issue but raises problems related to uniform retrieval, storage, sizing and availability. Early results are encouraging with the majority of patients experiencing pain relief and improvement of function over time.
