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Homologous meniscus transplantation

Experimental and clinical results

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Summary

The increase in severe ligament injuries of the knee has led to consideration of the need for meniscal transplantation in reconstructive operations for chronic rotational instability. Transplantation of the medial meniscus was carried out in two groups of 15 sheep. In one group lyophilised, γ-sterilised allogenic menisci were transplanted and these underwent a complete remodelling in 48 weeks. In the other group, deep frozen allogenic menisci were used and these remained fully functional without remodelling. We then carried out meniscal transplantation in 22 patients who were followed-up for a mean of 14 months. Arthroscopy was possible in two-thirds of the cases at an average of 8 months after operation. Both types of transplanted menisci, lyophilised and deep frozen, decreased in size, as small as a regenerated meniscus in some cases. In general the deep frozen menisci showed better results.

Résumé

L'augmentation de fréquence des graves traumatismes ligamentaires du genou a conduit à envisager la transplantation méniscale dans les opérations reconstructrices pour instabilité rotatoire chronique. La transplantation du ménisque interne a été réalisée dans deux groupes de 15 moutons. Dans un groupe on a utilisé des ménisques allogènes lyophylisés et stérilisés aux rayons γ, qui ont présenté, à la 48ème semaine, une transformation complète. Dans l'autre groupe, on a transplanté des ménisques allogènes réfrigérés à −30° C et ceuxci sont restés parfaitement fonctionnels, sans transformation. Nous avons réalisé une transplantation méniscale chez 22 malades, qui ont eté suivis 14 mois en moyenne. Dans les deux-tiers des cas une arthroscopie a été possible vers le 8ème mois après l'opération. Les deux types de ménisques, lyophylisés et réfrigérés, diminuent de volume pour devenir aussi grêles, dans quelques cas, qu'un ménisque régénéré. Dans l'ensemble les ménisques conservés au froid donnent les meilleurs résultats.

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Authors and Affiliations

  1. Orthopaedic Clinic, Ludwig-Maximilians University, Marchionistrasse 15, D-8000, München 70, Germany

    K. A. Milachowski, K. Weismeier & C. J. Wirth

Authors
  1. K. A. Milachowski
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  2. K. Weismeier
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  3. C. J. Wirth
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Additional information

This work received the Müller-SICOT award in 1987

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Milachowski, K.A., Weismeier, K. & Wirth, C.J. Homologous meniscus transplantation. International Orthopaedics 13, 1–11 (1989). https://doi.org/10.1007/BF00266715

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