Meniscus replacement gets arthritic athletes back to sports

Stone Research Foundation study offers hope to former athletes who have a torn or missing meniscus cartilage and severe osteoarthritis.

A new long-term study of 49 patients who had their meniscus replaced, finds that athletes who replace their damaged or missing meniscus tissue with donor tissue can recover well enough to get back to sports for up to 15 years, even if they had already developed osteoarthritis. The study was carried out by the Stone Research Foundation and published on September 26, 2014 in the journal of Knee Surgery, Sports Traumatology, Arthroscopy.  

What’s new?

Previous studies have found that meniscus transplants can reduce pain and improve function for patients with missing or irreparable meniscus tears. Until now there has been little information on how the procedure works for patients who also have severe articular cartilage damage (osteoarthritis, OA) and want to participate in sporting activities.

The long-term study, published in the journal of Knee Surgery, Sports Traumatology, Arthroscopy, challenges current medical thinking that it’s not advisable to have a meniscus transplant if you have arthritis, and definitely not possible to return to sports.

About the study

The study included 49 patients from The Stone Clinic who had badly a damaged meniscus and severe cartilage damage and needed a meniscus transplant, typically the toughest patients to treat. Prior to their injury, they had all participated competitively in highly active sports such soccer, football, rugby, ice hockey, wrestling, squash, badminton, track and field, or downhill skiing. Each patient expressed a desire to get back to sport after his or her surgery.

All 49 patients had a meniscus replacement. 41 patients had a procedure to repair the damage to their articular cartilage.

Study results

  • 38 (78%) patients reported sustained improvements in pain, function and activity levels up to 15 years after their meniscus transplantation
  • 11 (22%) received an average of 5.2 years of benefit before requiring alternative treatment such as knee replacement
  • 36 (75%) patients participated in sports post-surgery
  • The study estimates that, on average, patients will benefit from this procedure for 12.6 years before requiring alternative treatment such as knee replacement

Conclusions

Meniscus transplantation is a viable surgical option for patients with severe cartilage damage and missing or irreparable menisci.  It provides significant improvement in pain and function levels in the medium to long-term with the majority of patients achieving their goal of participation in sporting activities.


OrthoReview: The Knee

More about the meniscus

Meniscus cartilage is vital to the healthy functioning of the knee joint.  It provides the cushioning between the thighbone (femur) and shinbone (tibia) and helps with shock absorption, stabilization, lubrication, and load distribution within the knee.  Tears to this tissue are common with an estimated annual incidence of 60–70 per 100,000.

A damaged or missing meniscus can lead to the development osteoarthritis, as the unprotected bones grind together.  By replacing all or a portion of the meniscus with donor cartilage, the patient can regain the natural “shock absorber” in the knee and avoid osteoarthritis.   

More about osteoarthritis

knee-osteoarthritis-illustration.jpg

Articular cartilage is the soft white cartilage that covers the ends of the bones and helps joints to move smoothly. Traumatic osteoarthritis comes from an injury that damages the articular cartilage, or when a patient’s meniscus cartilage has been damaged or removed following a sports injury. It is possible to repair the damage to the articular cartilage with an articular cartilage stem cell paste graft, which uses your own bone, cartilage and stem cells to  regenerate your damaged cartilage.


Meet Emily

Transient

Emily is an avid triathlete and skier but years of demanding training and competition had destroyed her meniscus, and severely damaged her articular cartilage. She had gone from doing two triathlons a year to hardly being able to walk without pain. At 48 years old, Emily had a meniscus replacement and articular cartilage repair. Six months later, Emily was back cycling. The following year, she competed in two triathlons. Now almost four years from surgery, Emily recently completed an Ironman with personal best times in both the swimming and cycling stages, earning her a top-third finishing time for her age group.

Emily says “It’s totally enabled me to continue being who I am, which is way more than just the sports that I do; it's part of my personality and I’m thrilled.