Meniscal allograft transplantation

Meniscal tears are the most common knee injuries, with a reported annual incidence of 61 per 100,000 people [1]. For years meniscectomy has been considered the gold standard treatment for meniscal lesions, due to the lack of knowledge regarding the role of the meniscus and the long-term effects of its deficiency. In fact nowadays, it is well known that even partial deficiency of the meniscus could be destructive for knee joint at long term. It is reported that meniscectomy increases the risk of developing knee osteoarthritis after 10 years of about 20 % for medial meniscus and 40 % for lateral meniscus [2] (Fig. 26.1). This is due to its important and irreplaceable functions, such as increasing congruity of the joint, reducing contact stresses, shock absorption, stabilization, proprioception, and cartilage lubrification and nutrition [3, 4]. For these reasons the management of meniscal tears changed dramatically over the years, from aggressive toward more conservative strategies. In this background meniscal substitution with allograft and more recently with scaffolds has been proposed in case of irreparable lesions.