Meniscal Transplant: Restoring a Knee That Has Lost Its Meniscus

For the knee, heavily loaded squats, especially with all the focus on upper body and inadequate lower limb conditioning, high-speed incline treadmill running, twisting exercises on a disc twister, and overloaded quadriceps extension machines are the most common causes of ACL ruptures and quadriceps or patellar tendon injuries. For the shoulder, wide-grip flies taken too far posteriorly can stress the joint, especially in anyone with a prior subluxation history. The most important message is to stop when the body signals pain rather than pushing through it.

A thorough history of the mechanism of injury tells a doctor about 70% of what they need to know, since mild pain from ordinary walking is very different from a pop felt during sport followed by an immediate fall. Persistent pain despite conservative treatment should not be dismissed as non-compliance; something is usually being missed and warrants an MRI. Any significant mechanism of injury deserves a low threshold for imaging without delay, since ACL repair rather than reconstruction is possible if the patient is seen within two to three weeks of injury. Once an MRI is available and there is uncertainty about the findings, a second opinion through Jivo can confirm whether the patient needs conservative treatment, local surgery, or referral to Artemis.

A single ligament reconstruction, ACL or PCL, costs approximately $4,000 to $4,500, all-inclusive from admission to discharge. Meniscal debridement alone is $2,500 to $3,000, and meniscal repair ranges from $4,000 to $5,000 depending on the number of suture anchors used, at roughly $500 each. A simple Bankart repair for shoulder instability costs $4,000 to $5,000, with remplissage adding about $1,000. PRP injections without surgery run about $500 per injection, with 3 to 4 injections typically needed over roughly six weeks.

Ligament reconstruction, ACL or PCL, has a 98 to 99% success rate, with failures very rarely seen. Meniscal repair success depends on how much of the meniscus is torn and how early the patient presents, but even large tears repaired a year after injury succeed around 90 to 95% of the time. Shoulder stabilisation surgery, Bankart repair or Latarjet, is 95 to 98% successful when planned correctly, and rotator cuff repair succeeds 90 to 95% of the time.

Blood supply to the meniscus runs from outside to inside, dividing it into three zones. The outer red-red zone near the capsule has decent blood supply, which is why peripheral tears heal well. The middle red-white zone has moderate blood supply and can still be repaired if augmented with orthobiologics. The innermost white-white zone has very poor blood supply, and a peripheral rim tear there is better debrided than repaired with multiple anchors into non-vascular tissue.

It is an arthroscopic procedure that implants a cadaveric meniscus from a young donor into a knee that has lost its own, with both roots repaired, multiple sutures anchoring it to the capsule, and PRP and BMAC added to support healing.

Young, high-demand patients with preserved cartilage who have lost their meniscus benefit most, since without intervention they typically develop severe arthritis by their late twenties or early thirties with few treatment options left by then.