A 30-year-old female presented with increasingly severe pain and swelling in her knee, restricting her activities. She had previously torn a meniscal cartilage when she was a teenager, with the torn cartilage having been surgically removed. Investigations confirmed complete loss of her lateral meniscus, with widespread erosion of the articular cartilage on the lateral femoral condyle and the lateral tibial plateau, with large areas of bare bone exposed. The patient’s knee alignment was normal and the joint was stable.
After detailed imaging plus an arthroscopic evaluation of the joint, the decision was made to proceed with a ‘Biological Knee Replacement’. The missing lateral meniscus was replaced with a donor meniscus, by meniscal allograft transplantation. At the same time, the areas of bare bone in the knee were resurfaced with chondrotissue® articular grafts. The patient was in hospital for just one night post-operatively, and her knee was protected in a brace and with crutches for the first six weeks, followed by a six-week course of physio rehab. The patient then spent the next six months performing carefully controlled exercises in the gym.
The patient was reviewed nine months post-op, and an MRI scan confirmed that the lateral compartment of the knee looked almost as good as new, with a new lateral meniscus and with a good layer of new articular cartilage covering the end of the femur and the top of the tibia. The patient was able to walk normally, with no pain and no swelling; she was going to the gym regularly, and was advised that she was well enough to return to full normal activities. To date, one year post-op, the patient is still 100% happy, symptom-free and active.
The field of soft-tissue reconstructive surgery in the knee is continuing to develop, with novel and exciting technologies becoming available on an ongoing basis. The surgical options available continue to expand, although careful appropriate patient selection is vital; as is choosing an appropriate surgeon with the experience and expertise necessary to deliver these complex techniques.