Meniscus transplants growing in popularity


Robin Filipski had undergone several knee surgeries after a skiing accident, but she says when the meniscus in her left her knee was finally gone, she was facing knee replacement.

"I still don't believe a knee replacement is something that is the time for me," Filipski said.

Instead, she chose what at the time was a newly emerging alternative -- a meniscus transplant, replacing the knee's natural cushion, with one taken from a cadaver.

"Immediately after my meniscus allograft, my husband and I took a bike tour," Filipski said.

San Francisco surgeon Dr. Kevin Stone often performs the technique as part of what he calls biological knee replacement. The procedure, which ABC7 first profiled in 2008, can also involve the resurfacing of damaged cartilage using a patient's own stem cells.

"You need to repair the articular cartilige surface and not just replace the meniscus," Stone said.

Since ABC7's report, Stone has opened the first dedicated meniscus transplant center in the country. His team has now performed the surgery on more than 200 patients. And he says several major insurance companies now cover all or part of the procedure in specific cases.

"Slowly the whole biologic field is growing, growing in acceptance as well," Stone said.

While meniscus replacement may be gaining wider acceptance, it's still controversial among many surgeons, including some who argue the technique is too risky.

"I've taken care of so many that have failed and in young people and it's really not a great outcome," Dr. Susan Lewis said.

Lewis is an orthopedic surgeon at St. Francis Hospital's sports medicine clinic in San Francisco. She cautions that a failed transplant can cause additional damage to the knee.

"If they fail, again, you have this large piece of tissue often flapping around in the knee and the knee doesn't tolerate that well and it can cause further damage," Lewis said.

She believes more study is needed on the procedures' safety and effectiveness.

What is clear is that the use of artificial knee replacements is surging as Americans exercise longer and harder. More than half a million procedures are now performed every year.

Dr. Stone says his data suggests a successful meniscus transplant could provide relief for about 10 years on average, allowing younger patients to postpone a knee replacement until later in life.

"So clearly we think the future of joint replacement, the future of joint repair is on the biolog side, tissue side, and we'll save the metal and the plastic until you're really old," Stone said.

Stone says the biologic surgeries can run from $10,000-$20,000 depending on the procedure. Artificial knee replacements can $20,000 and up, but are typically covered by insurance.

Written and produced by Tim Didion

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