Name of the Procedure:

Arthroscopy, knee, surgical; meniscal transplantation (includes arthrotomy for meniscal insertion), medial or lateral

Summary

Arthroscopic knee surgery for meniscal transplantation is a minimally invasive procedure where a damaged meniscus in the knee is replaced with a donor meniscus. This surgery involves both arthroscopy and arthrotomy (a surgical incision into the joint) to insert the new meniscus.

Purpose

Meniscal transplantation is performed to treat patients with severe meniscal damage or loss, which cannot be repaired through conventional methods. The goal is to reduce pain, improve knee function, and delay further joint degeneration.

Indications

• Severe meniscal damage or loss that causes significant pain and functional limitations.
• Young, active patients with meniscal deficiency.
• Patients with symptoms unresponsive to conservative treatments.
• No significant arthritis in the knee.

Preparation

• Pre-procedure fasting, typically for 8 hours.
• Adjustments to current medications as per doctor's advice, particularly for blood thinners.
• Preliminary imaging studies like MRI and X-rays.
• Pre-operative assessments, including physical examination and blood tests.

Procedure Description

1. Anesthesia is administered, often general or spinal anesthesia.
2. Small incisions are made around the knee.
3. An arthroscope (a small camera) and surgical instruments are inserted through the incisions.
4. The damaged meniscus is removed.
5. Via arthrotomy, the new donor meniscus is carefully positioned and secured in place.
6. Sutures or anchors may be used to secure the new meniscus.
7. Incisions are closed with sutures or staples.

Duration

Typically, the procedure takes about 1 to 2 hours.

Setting

The procedure is usually performed in a hospital or an outpatient surgical center.

Personnel

• Orthopedic surgeon specialized in knee procedures.
• Surgical nurses.
• Anesthesiologist or nurse anesthetist.
• Surgical technician.

Risks and Complications

• Infection.
• Bleeding or blood clots.
• Nerve or blood vessel damage.
• Graft rejection.
• Stiffness or decreased range of motion.
• Need for additional surgeries.

Benefits

• Reduction in knee pain.
• Improved knee function and mobility.
• Potential delay in the progression of arthritis.
• Enhanced quality of life.

Recovery

• Post-procedure care includes icing the knee, elevation, and limited weight-bearing.
• Pain management with prescribed medications.
• Physical therapy to regain knee strength and flexibility.
• Follow-up appointments for monitoring recovery.
• Full recovery may take several months, with gradual resumption of activities as advised by the physician.

Alternatives

• Partial meniscectomy (removal of damaged meniscus).
• Meniscal repair (if suitable).
• Physical therapy and pain management.
• Use of knee braces or orthotics.
• Pros and cons vary; meniscal transplantation is specifically beneficial for those with severe meniscal deficiency without significant arthritis.

Patient Experience

• The patient will be under anesthesia during the procedure, ensuring no pain is felt.
• Post-operatively, there might be some discomfort and pain, managed with medications.
• Swelling and limited mobility are expected initially.
• Physical therapy aids in recovery and gradually returns knee function.