Meniskusersatz

Not every meniscus tear can be repaired while still preserving the tissue. Thus, meniscus replacement is an interesting therapeutic option. It can be performed both by meniscus transplantation as well as replacement with autologous tissue or synthetic material such as a prosthesis or collagen scaffold. This contribution presents the current status of possible treatment modalities for meniscus replacement. It is indicated in young patients with symptomatic unicompartmental early arthrosis. It is only promising in a stable knee joint without axial deviation. An important prerequisite for successful replacement of the meniscus is restoration of joint mechanics. In addition to autologous transplants, allografts are also suitable for meniscus transplantation. Their advantage is that they are relatively easy to store and in principle are available in large numbers. Problematic is the potential risk of infection. Tendon transplants and Hoffa's fat pads are not appropriate for meniscus transplantation. Initial clinical experience has shown engraftment after 4-6 weeks and ingrowth of receptor cells in the transplants as well as distinct pain reduction. One tissue substitute material for the meniscus that has been clinically tested is the collagen meniscus implant. All techniques for meniscus replacement are, however, still in the experimental stage.