New knee repair brings hope

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Unless you have had the misfortune of tearing your meniscus, you may not even know what it is. A torn meniscus causes knee pain that can be a constant reminder of the importance of this shock-absorbing piece of fibrocartilage. The c-shaped cushion in the knee provides stability and is most often injured during activities in-volving impact and twisting.

Years ago, in-juring the meniscus could lead to lifelong problems. As Dr. Eric Verploeg of Orthopaedics of Steamboat Springs said, "The technology was just not available. A torn meniscus almost always meant removal."

Without the meniscus, joint surface pressures and motion are increased, causing progressive damage to the surfaces in the knee. Today, aggressive treatment is provided to try to preserve the meniscus.

A repair is made to the tear if possible, otherwise removal of only the damaged portion of the structure is completed. Every effort is made to keep the meniscal cartilage intact. In cases where these salvage procedures fall short and the meniscus cannot be saved, there may be another option.

A meniscal allograft is a relatively new procedure that may offer a second chance at a healthy knee. So, what is this innovative sur-gery? Let's start with the term allograft. An allograft is a tissue graft from a person who chose to be an organ and tissue donor. A match is then made based upon the size of the graft. Some people have waited months for this match to occur.

The surgery itself is mostly arthroscopic and uses similar techniques to those in a meniscal repair to sew the tissue into place. The allograft is well tolerated and the procedure usually can be done either as an outpatient or with a one-night stay.

"Recovery is similar to that of an ACL repair," said Dr. Michael Sisk of Orthopaedics of Steamboat Springs. "You want to regain muscle strength to protect the knee and reduce the risk of retearing or reinjuring. We are always shooting for greater strength."

Rehab is extensive, lasting for four to six months, but the expectation is good. Verploeg and Sisk have been performing the procedure for nearly two years. They anticipate the allograft will help to slow down the deterioration of the knee and prevent the joint from wearing out.

The best candidates for the procedure:

- are under the age of 40,

- lead an active lifestyle,

- have pain located to the side of the lost meniscus,

- have stable ligaments in the knee,

- preferably have little or no articular cartilage damage.

Although meniscal allograft has provided a ray of hope for some, long-term studies have yet to be completed. As Verploeg emphasizes, it may not be the perfect long-term solution.

"We will jump through hoops to repair the meniscus. An allograft is just not as good as what you already have. The best tissue you have is your own, " he said.

-- Heather Rose is a public relations assistant at Yampa Valley Medical Center.

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