Meniscal Transplant Surgery
When a meniscus has been severely damaged or largely removed during a prior surgery, the knee loses the shock-absorbing cushion that protects the joint surface — and without it, the cartilage on the femur and tibia bears load it was never designed to handle alone. Over time, this leads to progressive pain, swelling, and accelerated cartilage breakdown that, left unaddressed, results in early-onset osteoarthritis. For older patients, knee replacement may be the appropriate next step. But for younger, active patients who have lost a significant portion of their meniscus and want to preserve their native joint, meniscal transplant surgery offers a biological solution — replacing the missing meniscus with size-matched donor tissue to restore the knee’s load-distributing function, relieve pain, and protect the remaining cartilage from further deterioration.
Dr. Jonathan Glashow is a board-certified orthopedic surgeon and Clinical Associate Professor of Orthopedic Surgery at NYU Grossman School of Medicine, with published research in the Journal of Bone and Joint Surgery on meniscal diagnosis and over 30 years of experience performing advanced joint-preservation procedures. Meniscal transplant is one of the most technically demanding arthroscopic surgeries — requiring precise donor tissue sizing, meticulous graft preparation, and expert arthroscopic placement to ensure the transplanted meniscus functions as a true load distributor within the joint. With fellowship training in arthroscopic surgery at the Southern California Orthopedic Institute/UCLA, membership in the Arthroscopy Association of North America, and more than 15,000 procedures performed over his career, Dr. Glashow has the specialized expertise this procedure demands. As Chief Medical Officer for the New Jersey Devils and Philadelphia 76ers, he manages meniscal injuries and joint-preservation decisions in professional athletes where protecting long-term knee health is as important as returning to competition. Named a Castle Connolly Top Doctor every year since 2000, he performs meniscal transplant surgery at his Upper East Side practice in New York City.
When Meniscal Transplant Is Recommended
The most common reason for performing a meniscal transplant is when a patient has previously lost a meniscal cartilage in their knee and have developed early degeneration, with pain in the knee and decreased function. Another potential reason for performing a meniscal transplant is to replace the shock absorber inside the knee and therefore help protect the knee and reduce the likelihood of the knee developing arthritis in the future.
Meniscal surgery is performed using an arthroscope, a small fiber-optic TV camera that is used to see and operate inside the joint. Only small incisions are needed during arthroscopy. The NYC orthopedic surgeon does not need to open your knee joint.
Candidacy Criteria for Meniscal Transplant
The criteria for meniscal transplant surgery includes:
- Younger than 50 years old and physically active
- Missing more than half of a meniscus as a result of previous surgery or injury, or a meniscus tear that cannot be repaired
- Persistent pain
- Knee with stable ligaments and normal alignment
- Minimal knee arthritis / no arthritis of the knee
- Are not clinically obese
Meniscus replacement is considered by the NYC orthopedic surgeons when:
- The patient is healthy and wishes to remain active.
- The patient understands the need for rehabilitation. The patient experiences pain located in the same area, from which a significant portion of meniscus has previously been removed no less than six months prior.
- The knee alignment is normal with stable ligaments.
- The knee does not have significant injury to the articular (gliding surface) cartilage or evidence of arthritis on x-rays.
If you have lost a significant portion of your meniscus from prior surgery or injury and are experiencing persistent knee pain, swelling, or functional limitations, meniscal transplant may be able to restore your knee’s protective cushion and delay the need for joint replacement. Dr. Glashow offers comprehensive evaluation with same-day imaging at his Upper East Side practice to determine whether you are a candidate for this joint-preservation procedure. Contact our office to schedule your consultation.
Frequently Asked Questions About Meniscal Transplant Surgery
What is a meniscal transplant?
A meniscal transplant is a surgical procedure in which a damaged or missing meniscus is replaced with donor meniscal tissue from a tissue bank. The donor meniscus — called an allograft — is carefully size-matched to the patient’s knee using X-ray and MRI measurements to ensure a proper fit. The graft is implanted arthroscopically through small incisions and secured to the tibia using bone plugs or suture fixation, restoring the knee’s shock-absorbing cushion and load-distributing function.
What is the difference between meniscal repair and meniscal transplant?
Meniscal repair involves stitching a torn meniscus back together so the patient’s own tissue can heal. A meniscal transplant replaces the meniscus entirely with donor tissue when the patient’s own meniscus is too damaged, too deficient, or has already been surgically removed and cannot be repaired. Repair preserves the native meniscus and is always preferred when possible. Transplant is reserved for patients who have already lost a significant portion of their meniscus and are experiencing symptoms as a result.
How successful is meniscal transplant surgery?
Meniscal transplant surgery has approximately a 90 percent success rate for providing meaningful pain relief and improved knee function in appropriately selected patients. Long-term studies show that transplanted menisci can survive and function for many years, significantly delaying the progression of arthritis and the need for knee replacement. Success depends on proper patient selection — including normal knee alignment, stable ligaments, minimal existing arthritis, and appropriate body weight — as well as the precision of the surgical technique.
Will I need to stay in the hospital after meniscal transplant surgery?
Meniscal transplant is typically performed as an outpatient procedure when it is the only surgery being done. However, if the transplant is combined with another procedure — such as ACL reconstruction, cartilage restoration, or a tibial osteotomy to correct alignment — an overnight stay may be recommended. Dr. Glashow discusses the expected surgical plan and recovery logistics with each patient during the pre-operative consultation.
What does recovery look like after meniscal transplant surgery?
Patients typically wear a knee brace and use crutches for the first one to four weeks after surgery, with early range-of-motion exercises beginning within the first few days to prevent stiffness. A structured physical therapy program progresses through strengthening and functional training over the following months. Most patients return to daily activities within two to three months, and full rehabilitation — including a return to sports or physically demanding work — generally takes three to six months. Dr. Glashow coordinates rehabilitation closely with physical therapists and provides each patient with a specific recovery timeline based on their procedure and individual healing progress.
Can meniscal transplant be combined with other knee procedures?
Yes. Meniscal transplant is frequently performed in combination with other procedures to address the multiple factors that may be contributing to the patient’s knee dysfunction. Common combinations include ACL reconstruction in patients with both meniscus deficiency and ligament instability, high tibial osteotomy to correct alignment in patients with bow-legged deformity overloading the medial compartment, and cartilage restoration procedures such as ACI implantation for patients with associated articular cartilage damage. Dr. Glashow evaluates each patient’s full clinical picture and recommends the combination of procedures that will provide the most comprehensive and durable result.
