Autogenous tendon graft substitution for absent knee joint meniscus: a pilot study

Area of Science:

• Orthopedic Surgery
• Regenerative Medicine
• Biomaterials Science

Background:

• The meniscus plays a crucial role in knee joint function, shock absorption, and stability.
• Absence of the meniscus, particularly the lateral meniscus, can lead to pain, instability, and degenerative arthritis.
• Autogenous tendon grafts have been explored as a potential biological substitute for meniscal tissue.

Observation:

• A pilot study investigated the use of autogenous semitendinosus or patellar tendon grafts in five patients with absent lateral menisci and severe degenerative arthritis.
• Surgical procedures involved arthroscopic implantation of the tendon graft alongside debridement.
• Follow-up included second-look arthroscopy and biopsy in four patients between 9 and 24 months post-surgery.

Findings:

• Tendon grafts exhibited partial physical integrity but did not fully convert to fibrocartilage.
• The grafts failed to preserve the joint surface or provide significant symptomatic relief.
• Only one patient reported minimal clinical improvement; others remained unimproved, with two requiring further reconstructive surgery (knee replacement or fusion).

Implications:

• Autogenous tendon grafts, as utilized in this study, are not a viable substitute for absent knee menisci.
• The hypothesis that tendon grafts could restore meniscal function was not supported by the study's outcomes.
• Findings highlight the need for revised strategies and protocols in developing effective meniscus regeneration techniques.