Meniscus (Specialist Prof. Siebold)
Our specialty is to preserve your meniscus by repair
The meniscus is a cartilage between the femur and the tibia and is the most important structure in the joint. It is a buffer between the bones and protects the cartilage against overload, early destruction and osteoarthritis. The meniscus cannot repair itself because cartilage does not have a good blood supply. The spontaneous healing potential is very low, so it has to repaired by surgery.
Tibial plateau with medial and lateral meniscus (preparation Prof.Siebold/Metz)
Healthy meniscus between femur and tibia
A meniscal damage is usually caused by a trauma, e.g. in sports or an accident. Usual daily and sportive activities are restricted. The knee can be stiff, swolen and painful, especially when the knee is rotated.
For examination it is recommanded to consult a knee specialist. In case of any suspicion of injury an MRI (magnet resonance imaging) should be performed to visualize the meniscus. In most cases radiographs are ncessary to judge the degree of joint deformity and osteoarthritis while standing.
Unstable large meniscus bucket handle tear and torn meniscus, which locks the joint
Meniscus repair is absolutely necessary!
It is mandatory to preserve as much of the meniscus tissue by repair as possible. The amount of meniscus, which can be preserved, depends on the tear pattern and meniscus quality. All meniscal tears in kids and adults caused by an accident are usually repairable. In case of degeneration of the tissue healing of the meniscus might not be possible, so the torn part has to be removed from the joint, when painful. Prof. Siebold is highly specialised and very experienced on repairing meniscus tissue by an arthroscopy. The rate of meniscal repairs at our centre is by far higher than that of meniscal removals. We use all suture techniques and meniscus implant fixation techniques to preserve your meniscus as prestine as possible.
1) FastFix Suture Implant (Fa. Smith & Nephew) 2) Meniscus repair with FastFix 3+4) Meniscus-bucket handle tear repair by sutures
MENISCUS TRANSPLANTATION WITH ALLOGRAFT
In case of meniscus loss the load on the cartilage increase significantly. This usually leads to pain, swelling and early cartlage damage followed by early osteoarthritis. The situation is worse on the lateral side of the knee compared to the medial side.On the onset of symptoms an examination and MRI/radiographs are necessary to see the extend of meniscus loss and cartilage damage. The implantation of a ""meniscus allograft" is a good solution, especially for young patients to reduce pain, allow some activity & sports and slow down the development of early osteoarthritis. A meniscus allograft is human tissue and comes from an international tissue bank. At the moment an allograft is the only tissue which can be a substitute for our own meniscus. It has to be seen as a biologic implant. Unfortunately there are no artificial synthetic meniscus implants avaible, which can overtake the function of our meniscus. Prof. Siebold implants about 15-20 meniscus allografts every year since more than 10 years. Very often the leg axis and/or the cartilage might have to be treated, too. The surgery can only be performed by specialists and takes about 2h. The 10-year survival rate of a meniscus allograft implant is about 75-80%.1) Allograft before implantation 2) Allograft before implantation
1) Knee joint with meniscus defect and crtilage lesion 2) Allograft after implantation 3) Healed meniscus allograft
Rehabilitation after Meniscus repair and transplantation
After a partial meniscus resection full weight bearing and a free range of motion of the knee is allowed from postoperative day 1.
When the meniscus is repaired by sutures and implants partial weight bearing (10-20kg) on crutches is recommanded for 2-3 weeks and free range of motion.
IN case of meniscal allograft implantation 4-5 weeks of partial weight bearing is necessary and free range of motion.