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Meniscal Transplant - Tyler Welch, MD
York, ME (207) 363 3490 | Portsmouth, NH (603) 431 1121

20Hip Care
10Hip-Conditions and Injuries
Cartilage Injury
Femoroacetabular Impingement (FAI)
Gluteal Tears
Hamstring Tears
Hip Instability
Deep Gluteal Space Syndrome
Labral Tears
Psoas Impingement (Internal Snapping Hip)
PVNS
Trochanteric Bursitis
10Hip-Treatment and Surgeries
Acetabuloplasty
Chondroplasty
Femoroplasty
Gluteal Repair
Labral Debridement
Labral Reconstruction
Labral Repair
Nanofracture
Psoas Release
Trochanteric Bursa Debridement
33Knee Care
13Knee Conditions and Injuries
ACL Tear
Cartilage Injury
Discoid Meniscus
Lateral Meniscus Tear
LCL Injury
MCL Injury
Medial Meniscus Tear
Osteoarthritis
Osteochondritis Dessicans
Patellar Instability
Patellofemoral Chondromalacia
Posterolateral Corner Injury
Trochlear Dysplasia
20Knee Treatment and Surgeries
Anterior Cruciate Ligament (ACL) Reconstruction
Cartilage Restoration Surgery – Autologous Chondrocyte Implantation (ACI-Carticel)
Cartilage Restoration Surgery – Donor Graft
Collagen Meniscal Implant (CMI)
Lateral Collateral Ligament (LCL) Reconstruction
Medial Collateral Ligament (MCL) Reconstruction
Meniscus Repair
Meniscus Root Repair
Meniscal Transplant
Medial Patellofemoral Ligament (MPFL) Reconstruction
Nanofracture
Osteochondral Allograft Transfer
Osteochondral Autograft Transfer (OATS)
Partial Knee Replacement (MAKO)
Partial Meniscectomy
Posterior Cruciate Ligament (PCL) Reconstruction
Posterolateral Corner (PLC) Surgery
Tibial Tubercle Osteotomy
Total Knee Replacement (MAKO)
Trochleoplasty
20Shoulder Care
10Shoulder-Conditions and Injuries
AC Joint Injuries
Arthritis
Biceps Tendon Injuries
Calcific Tendinitis
Clavicle Fractures
Frozen Shoulder
Labral and SLAP Tears
Rotator Cuff Injuries
Shoulder Dislocation/Instability
Subacromial Impingement/Busitis
10Shoulder-Treatment and Surgeries
A-C Joint Stabilization
Biceps Tenodesis
Clavicle Fracture Fixation
Pectoralis Major Repair
Rotator Cuff Repair
Shoulder Instability Surgery – Bankart Repair
Shoulder Instability Surgery – Latarjet Procedure
Subacromial Decompression and Acromioplasty
Superior Capsular Reconstruction
Total Shoulder Replacement

MENISCAL TRANSPLANT

The meniscus is a pliable substance that sits between two bones in the knee joint, the femur (thigh bone) and tibia (shin bone). Some patients with meniscus tears can be treated with a combination of activity modification and a focused physical therapy program. Some patients who have had previous meniscus surgery may develop pain and instability due to limited functioning meniscal tissue. In such patients, Dr. Welch may recommend a meniscal transplant. A meniscal transplant involves transferring a healthy meniscus from a donor and securing it to the patient’s knee where the meniscus is deficient.

Dr. Welch prefers a “bone-plug” technique for meniscus transplantation. Prior to surgery, Dr. Welch measures the size of the deficient meniscus using x-rays and/or an MRI. A donor with a similar sized meniscus is identified and the tissue is cleaned and prepared appropriately prior to surgery. During surgery, Dr. Welch positions the donor graft in the knee and secures the bone part of the graft to the tibia bone with a medical screw (interference screw). Next, Dr. Welch uses a suture-passing device to attach stitches form the donor meniscus to the capsule (a soft tissue pouch that surrounds the knee). The stitches are then secured with square knots. These stitches help stabilize the meniscus and keep the meniscus in the appropriate position during the healing phase.

Post-Operative Rehabilitation

Following surgery, patients are placed in a hinged brace that is locked straight. Dr. Welch recommends partial weight bearing for 4-6 weeks in the brace. When the patient is sitting or lying down, Dr. Welch encourages knee range of motion from 0-90 degrees with the brace removed for the first few weeks after surgery. Dr. Welch also recommends intermittent icing and straight leg raise exercises to strengthen the quadriceps muscles. Dr. Welch recommends starting physical therapy two weeks after surgery. Physical therapy focuses on reducing swelling in the knee, restoring full range of motion, and eventually, restoring strength to the knee. Most patients can start full weight bearing on the affected leg 4-6 weeks after surgery. Most patients start cutting activities and sporting activity approximately 4-6 months after surgery.


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