Arthritis and Knee Surgery: New Twist
Transplanted Connective Tissue May Survive in Some Patients With Severe Arthritis
May 12, 2006 -- People with severely arthritis-damaged knees may still be candidates for a certain type of knee surgery called meniscus transplantation.
So says a study in Arthroscopy: The Journal of Arthroscopic and Related Surgery. The researchers who worked on the study included Kevin Stone, MD, of The Stone Research Foundation in San Francisco.
Stone's team studied 45 people with knees that were seriously damaged by arthritis. The patients were 48 years old, on average, and got a total of 47 meniscus transplants.
The menisci are connective tissue around the knee that help keep the knee stable. The transplanted menisci came from organ donors.
The point was to see if the meniscus can survive in an arthritic joint, write Stone and colleagues.
The researchers report that 42 out of the 47 transplants (about 89%) survived for two to seven years in arthritic knees.
Many of those knees also underwent other procedures at the same time, including cartilage treatment and stabilization. The study also included a 12-week rehabilitation program after meniscus transplantation.
The patients also rated their pain, sports-like physical activity, and daily functioning before surgery and about six years later, on average, showing improvement in all of those areas.
All of the patients with failed transplants had "unremitting pain" in the affected area that led to the transplant's removal or further joint surgery. The transplants tore and needed partial removal or surgical repair in 10 of the 47 transplants.
Delaying Knee Replacement?
"By offering meniscus allograft to young and old patients, the promise of greater mobility, comfort and quality of life includes delaying the time when joint replacement is needed," Stone says in a news release. "The meniscus replacement permits running and impact sports which are contraindicated in joint replacement."
Three patients had complications following the transplant.
One of those patients had severe pain that required the transplant's removal. Another patient had an inflamed vein (phlebitis). A third developed a blood clot that traveled to the lungs (pulmonary embolus) that was treated.
The researchers note that their study wasn't designed to see if transplanted menisci function as a normal meniscus would. "The goal of the study was to determine if the graft can survive," Stone's team writes. "A controlled study with and without the implant will help clarify the implant's contribution."