FAILED MENISCUS TRANSPLANTATION - A REPORT OF 3 CASES

Treatment of patients with an established disabling compartment arthro sis after total meniscectomy is an important clinical problem. Menisca l transplantation may be an alternative method of treatment, Between 1 989 and 1992, 25 cryopreserved nontissue antigen matched meniscal tran splantations were performed. In three patients with a medial meniscus, the transplantation failed because of partial loosening of the menisc us. The donor meniscus was removed in one case after 12 months and in the other two cases after 20 and 24 months. In two cases, there was a varus malalignment of the knee. In the third case, the knee was unstab le because of an insufficient anterior and posterior cruciate ligament . The retrieved menisci were stained with enzyme and immunohistochemic al reactions. Focal areas of degeneration were noted, with vital cells around the microvascular supply and at the synovial side. The growth potential of vital parts of the grafts, as shown by proliferation mark ers, seemed to be virtually nil. The success of meniscal transplantati on seems to depend on factors responsible for vascularization. Malalig nment and instability of the joint, causing abnormal pressure on the g raft, may be responsible for vascular damage leading to degeneration a nd loosening of the graft.