University of Virginia Health System

U.VA. DOCTOR PERFORMS FIRST CADAVER MENISCUS TRANSPLANT IN CENTRAL VIRGINIA

For those who have had a meniscectomy - a type of knee surgery - just walking to the car can be a miserable experience. A meniscectomy is the removal of the meniscus, the crescent-shaped wedge of shock absorbing tissue located in the knee in between the cartilage that covers the ends of both the thigh bone (femur) and the shin bone(tibia). The removal of the meniscus can cause severe pain in the knee making it painful to walk or perform daily activities, and can contribute to the early onset of osteoarthritis.

But now there is good news for those patients. Dr. Mark Miller, associate professor at the University of Virginia Health System, has performed the first cadaver-meniscus transplant in the central Virginia region. The procedure involves taking a meniscus from a cadaver and surgically attaching it in the knee of a patient who is without a meniscus.

The procedure was performed on a patient who suffered a knee injury during a high school football game. "This particular patient is a young athletic individual who was walking with a lot of pain, walking with a limp and was unable to run," Miller said. "This procedure should give him the ability to walk without a limp, be able to run and participate in sports and activities like anybody his age."

And now, two months after the procedure, the patient is back at work as a volunteer firefighter and has taken up jogging and mountain climbing.

Dr. Miller emphasizes that this procedure isn't for everybody, though. "We like to get patients who don't have a great deal of arthritis, so typically that is a younger patient who hasn't had a large interval since they had their meniscus removed. If you have arthritis your cartilage on the end of the bone will wear out becoming like sandpaper and it will simply wear away the new graft," Miller said.

Each year, nearly one million Americans injure their meniscus. Damage to the meniscus, presented as a tear, can occur by sudden twisting of the knee or by blunt forces exerted on the meniscus. If the tear is too large to be surgically repaired, then the meniscus has to be removed.

February 11, 2003