Best procedure for replacement of cartilage from a menisectomy.

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In march of 2002 I had a menisectomy in my right knee. 20% removal followed by 12+ weeks of PT. Eight months later severe pain returned just after a partial 25LB. weight restriction return to work. So a second arthroscopy was performed after MRI produced a necrotic section in rt. femor. An Osteochondroplasty was performed with 8weeks of 0 pressure bearing on leg as the initial part of my recovery. I have just finished 15 weeks of PT and leg is still unstable and painful. I am 32 years old and this has severly had an effect on my life. I am told a partial bone graph with cartilage would be my last option. I would like to have the best for this procedure. I need a response yesterday unfortunately. This was a work related accident and all expenses to date have been fulfilled, but I am receiving pressure to close this case. As of this moment a decision needs to be made this week and will determine a partial fate of my physical condition for the rest of my life. I am 6 feet 6inches tall and 250lbs. My work prior to the accident involved heavy labor and much physicalness. I have been very active in the past and would like to achieve a much higher percentage of activity than I am faced with at the moment. Any response would be most appreciated, can't say how much to be truthful. I reside in Pooler, Ga. just outside of Savannah, Ga. Thankyou and sincerely, Scott Andrew Morgan

-- Scott Andrew Morgan (samorgan4@comcast.net), May 04, 2003

Answers

I canít really answer this question without xrays and MRIís. How big is the avascular necrosis? How much cartilage damage is there? How much deformity of the leg? How much arthritis? These are all important to what is the best answer. If the AVN is small and there is not much cartilage damage then an osteochondral allograft would be a good choice. Iím sorry to not be more helpful.

-- Marc Hungerford, M.D. (mhunger@jhmi.edu), May 05, 2003.

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