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Meniscal allograft transplant is a rare surgery to replace a missing or torn meniscus, a 'C' shaped cartilage present in the knee. This type of cartilage acts as shock absorbers between your thighbone (femur) and your shinbone (tibia) and helps your bones move smoothly. Sometimes, a twisting injury may cause severe damage to your meniscus, requiring it to be removed. In the absence of this meniscus cushion, the ends of your tibia and femur may start to rub together abnormally. Over time, this can cause persistent knee pain and eventually arthritis. Meniscal transplant surgery replaces your missing or damaged meniscus with a donated meniscus.
For the first, such rare transplant was performed in the Telugu states on a 26-year-old Somalian patient. The surgery was conducted by Dr. Shashi Kanth G, Senior Consultant Orthopaedic and Arthroscopy Surgeon, from Yashoda Hospitals, Somajiguda Hyderabad and his team.
The patient, Abdikarim Ahmed Abdi, came to the hospital in March this year with complaints of left knee pain and instability. He had previously undergone a medial meniscectomy in 2018 and in view of the instability he underwent an ACL reconstruction in 2019. Unfortunately, even after the two surgeries, his symptoms persisted and worsened with time.
Dr. Kanth, who was his primary surgeon, conducted a detailed clinical and radiological evaluation, post which he decided to proceed with Revision ACL reconstruction with Meniscal Allograft and IT band tenodesis to get the knee more stable and pain free. The Allograft needed for surgery was procured from Musculoskeletal Transplant Foundation USA. Yashoda Hospitals received a Frozen Cadaver Meniscal graft which was delivered on 29th night transported in dry ice, maintaining the cold chain.
Abdi underwent surgery on 30th June and the procedure consisted of Meniscal Allograft Transplantation with Revision ACL (anterior cruciate ligament) reconstruction with PTB graft (Patellar Tendon-Bone) and IT band tenodesis.
Explaining the rare procedure, Dr. Kanth said, "A detailed clinical evaluation was done of Abdi's knee and all relevant scans were taken to make sure that the meniscus would fit Abdi's knee. The meniscus cadaver allograft was procured from Musculoskeletal Transplant Foundation, USA after proper matching of the size. Surgery was performed with Arthroscopic assistance under General Anaesthesia. The remnants of the meniscus tissue and ACL were debrided. Bed prepared for the meniscus allograft and it was fixed in its normal anatomical site with multiple sutures. Revision ACL surgery and IT band tenodesis were completed as well."
"After the surgery, Abdi was given a knee brace to wear for the first 6 weeks and was advised to walk with the help of a walker. He will not be allowed to put weight on the leg for at least 6 weeks. We asked him to gently move the knee right after surgery to prevent stiffness. His knee flexion will be allowed to increase gradually to 90 degrees in the next 4 to 6 weeks. He will undergo a long period of rehabilitation to build up his muscle strength and improve his knee movement."
His surgical team included three other renowned doctors from Yashoda Hospitals Hyderabad, including Dr. G. Vedaprakash (Consultant Orthopedic & Trauma Surgeon), Dr. Praveen Mereddy (Consultant Joint Replacement & Trauma Surgeon) and Dr. R. A. Purnachandra Tejaswi (Consultant Orthopaedic Surgeon). They came together to ensure a successful outcome for Abdi with this rare transplant.
After meniscal allograft transplant, patients take some time for rehabilitation and recovery before the full functional result can be achieved.
Abdi is now stable and walking pain free and talking about his recovery, he said, "I had tried different methods to ease my knee pain but nothing helped until Dr. Shashi Kanth diagnosed my ailment and gave me the appropriate treatment. I have gained confidence and strength to walk steadily again."
Abdi understands that he is in for a long journey of rehabilitation and recovery. He further added that the Meniscus allograft transplantation is a difficult surgery, the recovery can be hard, and that people having knee pain should get themselves checked and if required should proceed with a transplant, as it can boost their confidence and can bring about a transformative change in their lives.
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