The procedure is indicated when there is no effective rim of meniscus remaining to support the joint surfaces. This occurs when there has been a large tear and when it was not possible for the surgeon to salvage the meniscus by repairing it. Not everyone needs a transplant but if there is progressive pain and symptoms limiting activity then the procedure may be indicated.
There is often a feeling that it is necessary to always replace the meniscus if it is removed, based on the argument that it will prevent or delay the onset of later arthritis. This is a difficult issue, but because the rehabilitation period is long and because the operation is not without risks, meniscal transplantation is usually only performed when symptoms of pain on activity begin to cause interference with quality of life
The quality of the result of the operation is a key factor in deciding the indications as the replacement tissue is, after all, a donor graft that may not be as strong as the original and it takes time for it to fully integrate into the knee. Having invested a year of time in getting it right after surgery the thought of going back to full contact sports such as football and rugby could be considered ill-advised!
Recent research looking at the outcome by the leading surgeons in the US and in Europe would indicate that at 10 – 13 years approximately 70% of patients still have good function and have not had further surgery. Most have been able to do light sports. The occasional professional athlete may report being able to get back to high level but it should be remembered that professional athletes may have different goals.
Following surgery the rehabilitation process involves using a knee brace for the first 6 weeks while the new meniscus heals in place. The rehabilitation regime is given below.