Meniscal Repair and Transplantation: Indications, Techniques, Rehabilitation, and Clinical Outcome

Abstract

The purpose of this paper is to provide current knowledge regarding the indications, operative techniques, rehabilitation programs, and clinical outcomes of meniscus repair and transplantation procedures. Meniscus tears that occur in the periphery may be repaired using a variety of operative procedures with high success rates. Complex multiplanar tears that extend into the central one-third avascular zone can also be successfully repaired using a meticulous vertically divergent suture technique. The outcome of these repairs justifies preservation of meniscal tissue, especially in younger athletic individuals. Meniscal transplantation is a valid treatment option for patients who have undergone meniscectomy and have related tibiofemoral joint pain, or in whom articular cartilage deterioration in the meniscectomized compartment is present. Rehabilitation after these operations includes knee motion and quadriceps-strengthening exercises initiated the first day postoperatively. The initial goal is to prevent excessive weight bearing and joint compressive forces that could disrupt the healing meniscus repair or transplant. The protocol contains modifications according to the type of meniscal tear, if a concomitant procedure is done (such as a ligament reconstruction) or if noteworthy articular cartilage deterioration is present. Patients who have repairs of peripheral meniscus tears are generally progressed more rapidly than those who have repairs of tears extending in the central one-third region or those who undergo meniscal transplantation. The safety and effectiveness of the rehabilitation program has been demonstrated in several clinical studies. We recommend preservation of meniscal tissue, regardless of age, in active patients whenever possible.

Treating Human Meniscal Fibrochondrocytes with hIGF-1 Gene by Liposome

“…Many reports demonstrate an early onset of degenerative changes in the knee after meniscectomy [1,14,26]. Because there is a greater understanding of the importance of the menisci, most surgeons attempt to preserve as much functional meniscal tissue as possible when treating meniscal injuries [10,13]. Based on the blood and nutrition supply, the meniscus is divided into three zones: a red zone, a white zone, and a red-white zone [24].…”

Meniscus Repair and Transplantation: A Comprehensive Update

“…When indicated, the cast is used within the first 4 weeks for cases resistant to the other overpressure extension modalities. Casting is not recommended 22 with permission. in knees with greater than a -12° extension deficit with a hard block to terminal extension.…”

“…In the 5 years since our last update on this topic in the JOSPT, 22 further longer-term data have been published supporting both meniscus repair 30,48,62 and meniscus transplantation. 63,69,73,76,77 The operative techniques and rehabilitation programs remain relatively similar, as do the indications and contraindications.…”

Chiropractic management of a medial meniscus tear in a patient with tibiofemoral degeneration: a case report

“…The patient was advised to perform isometric VMO exercises for periods up to 30 seconds, in conjunction with the facilitaping (Fig 6A, B). 3,9,27,28,[37][38][39] Exacerbation of the knee pain was to be avoided during the rehabilitation exercises; that is, if the patient felt that the exercises were reproducing or aggravating the knee pain, she was to stop performing them. The patient received a total of 12 treatments over a 9-week period (2 treatments per week for 3 weeks, and 1 treatment per week for 6 weeks).…”