17220 Meniscal Transplantation

Overview

Meniscal transplantation is surgery to replace a damaged or missing meniscus with donated meniscus tissue. The meniscus is a rubbery, C-shaped cushion in the knee that helps spread load and protect the joint. This operation is also called meniscal allograft transplantation.

No. Meniscal transplantation is uncommon and is usually done by specialist knee surgeons in selected patients.

It mostly affects younger, active people who have lost a large amount of meniscus after injury or surgery. It can be considered in some children and teenagers, but only after specialist assessment because growth and knee alignment matter.

Symptoms

Common symptoms

• Pain in the knee, especially with twisting, squatting, or activity
• Swelling after activity or at the end of the day
• A feeling of catching, grinding, or giving way
• Stiffness or trouble fully straightening the knee
• Pain that limits sport, work, or daily walking
• Sometimes few symptoms, even when the meniscus is missing

Symptoms in children

• Knee pain or swelling after a twist or sports injury
• A knee that locks, catches, or feels unstable
• Avoiding sport or play because of knee pain
• In young children, the specialist will check growth plates and knee growth before considering any operation

Symptoms in older adults

• Knee pain and stiffness often due to wear-and-tear arthritis rather than a missing meniscus alone
• Swelling and pain with walking or stairs
• Transplant is less often offered when arthritis is advanced; other treatments are usually discussed first

Causes

Main causes

• A large meniscus tear that cannot be repaired
• Previous surgery to remove a large part or all of the meniscus, called meniscectomy
• Loss of meniscus after a knee injury
• Rarely, being born without a normal meniscus or losing meniscus because of other knee conditions

Risk factors

• Knee injuries, especially sports that involve twisting or pivoting
• Previous knee surgery to remove meniscus tissue
• Osteoarthritis or cartilage damage in the knee
• Being very active or having a job that puts heavy demands on the knees
• Knee malalignment or instability, which a specialist will assess

When to see a doctor

See a doctor urgently if:

• A knee injury with severe swelling, inability to bear weight, or a locked knee
• Fever, redness, or wound leakage after knee surgery
• Calf swelling or pain after surgery

Book a routine appointment if:

• Ongoing knee pain, swelling, or catching after a meniscus injury or meniscus removal
• You are considering meniscal transplantation and want to know your options
• You are struggling to return to sport, work, or daily activities because of knee symptoms

Diagnosis

There is no single test that decides whether you need a meniscal transplant. A clinician will ask about your knee history, examine your knee, and review imaging. If transplant is being considered, you will usually be referred to a specialist knee team. They will check whether the knee is stable and aligned, how much cartilage damage there is, and whether you can commit to a long rehabilitation programme.

Tests that may be done

• Medical history and knee examination
• X-rays to check alignment and arthritis
• MRI scan, or magnetic resonance imaging, to look at the meniscus, cartilage, and other knee structures
• Sometimes arthroscopy, which is keyhole surgery, to look inside the knee
• Pre-operative health checks, such as blood tests and heart and lung assessment, if surgery is planned

What to expect at your appointment

The assessment can take time. You may see a physiotherapist, radiologist, and orthopaedic surgeon. The team will explain the possible benefits and risks, and whether other treatments might be better for you. Do not feel rushed; asking for a second opinion is reasonable.

Treatment

Treatment usually starts with non-surgical options. These aim to reduce pain, strengthen the muscles around the knee, and help you stay active. Meniscal transplantation is considered only for selected people after a full specialist assessment.

Self-care at home

• Follow a physiotherapy programme to strengthen the thigh and hip muscles
• Use ice and rest when the knee is swollen, as advised
• Adjust activities to avoid deep squatting, twisting, and high-impact sport while the knee is painful
• Keep to a healthy weight to reduce load on the knee
• Use a walking stick, brace, or support if your clinician recommends it
• Build activity gradually rather than doing too much too soon

Medical treatments

Your GP or specialist may suggest simple pain-relieving or anti-inflammatory medicines, physiotherapy, activity changes, a knee brace, or injections for knee pain. These can help symptoms but cannot regrow a missing meniscus. Any medicine should be discussed with your clinician or pharmacist, especially if you have other health conditions or take other medicines.

When is surgery considered?

Meniscal transplantation may be discussed when knee pain and loss of function continue after a large part of the meniscus has been removed, the knee is stable and well aligned, cartilage damage is not severe, and you are willing and able to complete months of rehabilitation. The decision is made with an orthopaedic knee surgeon. It is not suitable for everyone, and alternative treatments will be discussed.

Living with this condition

If you are considering a transplant, you may need to plan around appointments and imaging. If you have surgery, expect a gradual recovery. You will usually need crutches and a brace at first, followed by physiotherapy over several months. Return to sport can take many months and varies from person to person. Follow your team's advice rather than comparing yourself with others.

Lifestyle tips

• Choose low-impact activities such as swimming, cycling, or walking as advised
• Keep muscles strong with a physiotherapy plan
• Avoid twisting and pivoting sports until your team says it is safe
• Pace yourself and build up activity slowly
• Use good footwear and consider shock-absorbing surfaces

Diet and exercise

A balanced diet with enough protein, calcium, and vitamin D supports muscle and bone health. Ask your clinician if you need supplements. Exercise is best guided by a physiotherapist; the goal is strong muscles, good knee control, and gradual return to activity without sharp pain or swelling.

Mental health and emotional wellbeing

Knee pain and surgery can be frustrating. You may feel anxious about recovery, sport, work, or money. It is common to feel low when progress is slow. Talk to your GP or specialist team if this affects your sleep, mood, or daily life. If you feel overwhelmed or have thoughts of harming yourself, contact your local crisis service or emergency services right away.

Prevention

You cannot always prevent a meniscus tear or the need for a transplant. You can lower the risk of knee injury by strengthening leg muscles, warming up, using good technique in sport, and avoiding sudden increases in training. If you have already lost meniscus tissue, physiotherapy and healthy activity can help protect the knee.

Vaccines

No vaccine prevents meniscal tears or the need for meniscal transplantation. Keep up with routine vaccinations recommended for your age and health, and follow any pre-surgery advice from your healthcare team.

Screening programmes

There is no routine screening test for needing a meniscal transplant. If you have ongoing knee pain after a meniscus injury or removal, see a clinician for assessment. Imaging may be used to check the knee, but it is not a screening test for everyone.

Complications

If left untreated

• Ongoing knee pain, swelling, and reduced activity
• More rapid wear of the knee cartilage and earlier osteoarthritis in some people
• Muscle weakness and loss of confidence in the knee
• Difficulty returning to sport or physically demanding work

Long-term outlook

The outlook varies. Many people who have a meniscal transplant have less pain and better knee function, especially when they follow rehabilitation and the transplant is done for the right reasons. The operation is not always successful, and some people need further treatment. Even if it does not work as hoped, your team can discuss other ways to manage pain and stay active.

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