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Knee Surgery

ELEVEN

Knee Surgery

Meniscal

Transplantation:

Donors make a

difference in

sports injuries

Up until relatively recently, cartilage tears

in the knee had to simply be ‘chopped out’

– removing the torn tissue but leaving the

knee with either a reduced, or even no,

shock absorber.Thankfully, nowadays, some

cartilage tears can be repaired successfully.

Mr Ian McDermott, Consultant

Orthopaedic Surgeon at London Bridge

Hospital states,“Knee cartilages naturally

have a very poor blood supply and

therefore only about 25% of tears can

actually be repaired, and that is in the

most expert hands.”

For those patients who have lost a

meniscal cartilage in the knee, sadly the

long-term consequences can be quite

grave, with an increased risk of future

arthritis in the joint of up to 1500%.

Fortunately, groundbreaking research

is ongoing with attempts to introduce

methods of replacing missing cartilage

tissue, to improve patients’ symptoms

and to try and reduce the risk of arthritis.

Various artificial scaffolds are being

developed whereby new cartilage tissue

grows into the implant. However, these

scaffolds are delicate and as yet can

only be used to replace relatively small

amounts of missing tissue. For those

patients who have lost large amounts of

cartilage tissue or even a whole meniscal

cartilage in its entirety, a small group of

surgeons in the UK are leading the way in

the technique of Meniscal Transplantation.

During Meniscal Transplantation, whole

meniscal cartilages are taken from donors

and tested, sterilized and stored.These

frozen cartilages can then be provided

to patients and transplanted into a knee

to replace missing tissue.The technique

is complex and is currently only being

undertaken by about half a dozen

surgeons in the UK.

Mr Paul Barraclough, a 39-year-old banker

from London, had had terrible trouble

with his knee, with a series of operations

relating to injuries from football. Paul had

previously undergone an anterior cruciate

ligament reconstruction in his knee, but

this had failed and he had ended up with

severe tears of one of the cartilages in

his knee. Mr Ian McDermott, Paul’s knee

specialist, stated,“When I met Paul, he

had no ACL in his knee, and after a series

of cartilage tears also ended up with no

meniscal cartilage. Paul was young and

determined to stay active and healthy and

wanted me to get his knee as close to

back to normal as possible.”

Mr McDermott performed a new ACL

reconstruction and a new meniscal

transplant in Paul’s left knee. Paul stated,

“Before this surgery I couldn’t run or

even manage a light jog without pain

and clicking in my knee.The operation

went well and afterwards I had a lot of

rehab, gradually building up the knee.

Now I can jog, ride a bike, I row four

times a week and also conduct football

training for my son’s football team. I would

definitely recommend the operation and

am grateful for the outcome and the

continued support I received from Mr

McDermott.”

Mr McDermott stated,“Meniscal

Transplantation is a complex and involved

procedure with very specific indications

that are not suitable for every patient.

However, those of us who have pioneered

the technique in the UK are seeing very

encouraging results, it can give patients

greatly improved function with the hope

of reduced risks of arthritis when they

get older. Also, as techniques improve and

technology develops, we are all looking

forward to the day when patients will

be able to ‘grow their own’ replacement

tissues.The future does look very exciting.”

Meniscal Transplantation is just one of

the reconstructive techniques available

from Mr Ian McDermott and the team

of specialist surgeons at London Bridge

Hospital.

Cartilage tears in the knee are one of the most common

but most debilitating sports injuries facing active people

today. The knee cartilages are two elastic shock absorbers

inside the joint that can often tear during heavy twisting

on a bent knee or from innocuous sports injuries. Knee

cartilage tears cause pain, swelling and clicking and can

cause the knee to give way or to lock up.

Mr Ian McDermott

MB BS MS FRCS (Orth) FFSEM (UK)

Consultant Orthopaedic Surgeon

T: 08445 617157

E:

[email protected]