Arthroscopic Meniscal Transplantation Technique

Cruz Lopez Francisco

doi:10.4172/2161-0673.1000171

Abstract

The meniscus provide several important mechanical functions in the knee joint. Following menisectomy the tibiofemoral contact area decreases while the contact forces increase. Meniscal allograft transplantation (MAT) offers the potential to restore partial load-bearing, decrease symptoms, and provide chondroprotective effect. Ideal patient for MAT should have normal alignment, stable knee, abscence of cartilage damage and has less than 50 years-old. Several open and arthroscopic MAT techniques have been described. The succesful of MAT is to use a minimal invasive technique without sacrificing the precise anatomic reconstruction of the original meniscofemoaral and meniscotibial relationships. Anatatomical position, appropriate sizing of the graft, and fixation method are crucial key points to have good results. In general there are three fixation methods: soft tissue fixation, suture fixation through transoseous tunnels, and bone plugs press-fit fixation. However, inferior biomechanical and contact pressure have been reported with soft tissue and transosseous tunnels compared with the bone block technique.

Highlights

Meniscus play an important role in load transmission, stability, lubrication and nutrition of the articular cartilage
Tibiofemoral contact area decreases by approximately 50%, while contact forces increase 2-fold to 3-fold and in consequence osteoarthric changes in the kne are well documented [2,4]
The goal of this study is to demonstrate the feasibility of arthroscopic meniscal transplantation using press-fit bone fixation and graft placement using tibial tunnels

Summary

Introduction

Meniscus play an important role in load transmission, stability, lubrication and nutrition of the articular cartilage. Tibiofemoral contact area decreases by approximately 50%, while contact forces increase 2-fold to 3-fold and in consequence osteoarthric changes in the kne are well documented [2,4]. Allograft transplantation technique offers the potential to restore function, provides chondroprotective effects, and decrease symptoms in appropriate patients after total menisectomy [2]. Ideal patient to meniscal transplantation is young (less than fifty years), stable knee, normally aligned and localized pain in the affected compartment [4,5,6]. There are relative contraindications to meniscal transplantation as ligamentous instability, malalignment, and cartilage degeneration. Prophylactic meniscus transplantation is not recommended in asymptomatic patients who do not have articular cartilage damage

Objectives

Methods

Results

Conclusion