A meniscus transplant is a surgery to replace a damaged or missing meniscus with one from a donor (someone who has passed away). It’s done to help restore function and reduce pain in the knee. A meniscus transplant surgery is complex and requires skilled doctors. There is a learning curve, and the surgery must be done carefully to make sure the new meniscus fits well and works properly.

1. Making an incision: The doctor makes a small cut next to the patellar tendon (the tendon in front of the knee).
2. Preparing the meniscus: The meniscus from the donor is carefully prepared and placed into the knee. For the medial meniscus (inside part), bone plugs are placed at both the front and back of the meniscus to help secure it in place. For the lateral meniscus (outside part), a bony trough is used to help hold the meniscus because the attachment points are farther apart.
3. Stitching the meniscus: After the meniscus is in the correct position, the surgeon sews it into place.

Patients are non-weight-bearing (not allowed to walk on the knee) for the first 6 weeks after surgery to allow the meniscus to heal. After that, they can slowly begin moving and putting weight on the knee again.

• Post-Operative Care: After a meniscus transplant, patients usually feel less pain and swelling, with many experiencing better knee function. Studies show that 80% of patients report good or excellent When done along with an ACL revision surgery, the knee can return to better stability and function.
• Returning to Activities: It’s controversial whether patients should return to impact activities (like running or jumping) after a meniscus transplant. If the knee has early arthritis (called chondromalacia), doctors recommend being careful with high-impact activities. This is because the donor meniscus might not handle the stress of those activities as well as a natural meniscus. Instead, doctors recommend low-impact activities like walking, swimming, cycling, and using an elliptical machine to stay active.

Before a meniscus transplant, doctors need to carefully check the knee to make sure it’s stable and properly aligned. They also check if there’s enough healthy cartilage left in the joint. This can be done using X-rays and MRI scans. If there’s bare bone exposed where the cartilage is missing, it may be possible to fix that with cartilage replacement surgery (like microfracture surgery). However, if the damage is too severe and there’s bare bone on both sides of the joint, a meniscus transplant may not be possible.

X-rays also help doctors make sure the knee alignment is normal. The right size meniscus must be chosen for the transplant to make sure it fits well and helps protect the joint. Regular follow-ups with X-rays are important to check for bone spurs or joint space narrowing, signs of arthritis. If these problems develop, a meniscus transplant might be needed to protect the knee.