Study confirms replacing the meniscus delays knee joint replacement in arthritic knees


SAN FRANCISCO, Aug. 14, 2024 - The publication of the study "Meniscus Allograft Transplantation in Conjunction with Arthroscopic Biologic Knee Restoration Delays Arthroplasty in Patients Over 50 Years of Age" in the peer-reviewed journal Arthroscopy provides evidence that meniscus replacement, once thought of as only for young people, not only relieves the pain of arthritis but delays joint replacement. The study potentially changes the thinking that people have to wait until they are older to solve the pain and limitations of arthritis by addressing a critical gap in the treatment options available for patients aged 50 to 70 who suffer from knee osteoarthritis.

The Stone Research Foundation, a San Francisco public non-profit entity, conducted the study on 84 patients over the age of 50 who received meniscal allograft transplants in the setting of significant arthritis. These patients, initially advised to consider joint arthroplasty, sought an alternative approach to delay or avoid arthroplasty. Remarkably, 48% of these patients managed to delay arthroplasty for an average of 8.64 years post-meniscal allograft transplantation and the other 42% never needed a joint replacement. The study encompassed a 2-25 year follow-up period.

Many of the patients combined cartilage regeneration procedures with the meniscus transplant demonstrating the viability of meniscal allograft transplantation for older patients when concomitant issues are addressed. The surgery provides an effective means to delay or avoid arthroplasty and maintain an active lifestyle. It emphasizes the importance of a comprehensive approach to knee reconstruction, addressing not only the meniscus but also damaged articular cartilage and ligamentous instability.

"Our study shows that meniscal allograft transplantation can be a viable solution for older patients for pain management and improved function," said Kevin R. Stone, M.D., Chairman of the Stone Research Foundation. "It is important to note that our study population was mostly limited to highly active patients with advanced knee osteoarthritis. These patients were determined to return to impact sports like skiing, running, and tennis and truly tested the limits of their meniscal allograft transplantations. They demonstrated that these joints, once restored biologically, can withstand a return to high levels of activity even if they are not completely symptom-free."

The background for the study shows a significant number of individuals aged 50 to 70 develop knee osteoarthritis, often precipitated by partial or total meniscectomies performed earlier in life to treat meniscal injuries. Patients under the age of 70 with osteoarthritis are often advised to delay arthroplasty due to the higher risk of needing revision surgeries. Additionally, innovative procedures to biologically repair and replace damaged knee tissues are often unnecessarily limited to younger patients.

"Patients around the age of 50 to 70 are in a gray area," commented Dr. Stone. "They face the dilemma of trying an arthroplasty and possibly risking multiple revisions or doing nothing and potentially enduring pain. Conservative care, including physical therapy, cortisone and lubrication injections, and activity modifications/limitations, may be recommended, but these treatments can be insufficient in managing the patients' pain. The conventional approach often limits patients to activities like cycling and swimming, avoiding impact sports. Our goal is to keep people playing forever."

The findings from this study contribute to ongoing efforts to expand the indications for meniscal allograft transplantation and biologic therapies in orthopaedics, potentially changing the standard of care for older patients with knee osteoarthritis.

About the Authors

Kevin R. Stone, MD, Founder and Chairman
Dr. Kevin Stone is an orthopaedic surgeon at The Stone Clinic and the Chairman of the Stone Research Foundation. He has lectured around the world as an expert in cartilage and meniscal growth, replacement, and repair and holds over 40 U.S. patents on novel inventions to improve healthcare.

Dr. Stone was trained at Harvard University in internal medicine and orthopaedic surgery and at Stanford University in general surgery. His fellowship was in research at the Hospital for Special Surgery and in knee surgery in Lake Tahoe. He is a physician for Smuin Ballet and has served as a physician for the U.S. Ski Team, the U.S. Pro Ski Tour, the Honda Ski Tour, the Jeep 48 Straight Tour, the Old Blues Rugby Club, Lawrence Pech Dance Company, Marin Ballet, the modern pentathlon at the U.S. Olympic Festival, and at the United States Olympic Training Center.

Mani Vessal, MA, Ph.D., Senior Director of Research & Operations
Dr. Mani Vessal has a background in medical anthropology and neurological sciences. He holds a doctorate in medical science and trained in neuroanatomy focusing on epilepsy at the University of Toronto, Canada. In 2008 he completed his fellowship at the Stanford School of Medicine in spinal cord injury and regenerative medicine and continued his research as a Sr. Scientist at Stanford. In 2010, Dr. Vessal joined the California Institute for Regenerative Medicine (CIRM), the stem cell agency, as a Sr. Scientific Officer, where he managed a large portfolio in translational and clinical programs in regenerative medicine.

As the Director of Research for the Stone Research Foundation, he oversees all current and future research programs and spearheads the growth of future funding streams to expedite the foundation's mission to advance therapies for treating and preventing arthritis.

About Stone Research Foundation
The Stone Research Foundation is an independent, 501(c)3 non-profit research institute with the mission to pioneer new regenerative orthopaedic treatments that accelerate healing, enabling people to stay active through research, development, innovation, and education.

SOURCE Stone Research Foundation