The meniscus is vital to the healthy functioning of the knee joint. Missing or damaged meniscus tissue can lead to the development of osteoarthritis. Our research informs meniscus allograft transplants (MATs) as a repair strategy to help prevent or delay knee replacement.
Total Patients Studied
MAT Procedures
Mean Follow-up
Allograft Survival
The meniscus is a soft, fibrous cartilage that sits between the femur and tibia. In a healthy knee, it acts as a natural shock absorber, helping distribute force across the joint. When meniscus tissue is damaged or removed, that force is transmitted abnormally, leading to cartilage wear, pain, arthritis, and loss of activities.
Meniscus tears are often treated by trimming or removing the damaged tissue. This can relieve symptoms in the short term, but the loss of meniscus tissue accelerates the process of joint damage and the onset of osteoarthritis (OA), causing pain and making it increasingly difficult for people to remain active over time.
SRF research demonstrates that replacing all or part of a damaged or missing meniscus with allograft (donor) cartilage can help restore its function. Our long-term findings challenge the assumption that age, arthritis, or demanding athletic goals must bring an active life to an end.
Patients once considered outside the traditional limits of transplantation may now have an opportunity to preserve their natural knee and return to high-level activity.
Through our clinical research and leadership of the Meniscus Transplant Study Group, SRF brings together international expertise to advance the science of meniscus transplantation and move discoveries into clinical care.
Expanding the Indications for Meniscus Transplantation
SRF research demonstrated that meniscus allograft transplantation can be successful in patients over 50 with significant arthritis, expanding treatment options for patients who might otherwise proceed directly to knee replacement.
Meniscus allograft transplantation was traditionally indicated for patients under age 50 with limited arthritis. Older age and arthrosis (degenerative arthritis) were commonly viewed as contraindications, ruling many patients out for the procedure.
In a long-term study, SRF examined patients over 50 with arthritic knees who had previously been advised to undergo arthroplasty (knee replacement surgery). The findings showed that meniscus allografts, used in conjunction with arthroscopic biologic knee repair procedures, can:
Survive in arthritic knees
Improve pain and function
Delay artificial knee replacement
SRF research established that patients with moderate to severe articular cartilage damage can return to sporting activities after meniscus allograft transplantation, challenging the belief that advanced cartilage damage should rule out both the procedure and a return to sports.
Meniscus allograft transplantation had already been shown to reduce pain and improve function in patients with missing or irreparable menisci. However, there was limited evidence about whether active patients with severe articular cartilage damage could achieve similar outcomes and resume sporting activities.
In a long-term study of 49 patients, SRF found that meniscus allograft transplantation provided significant improvements in pain and function in the medium to long-term. The majority of patients achieved their goal of participating in sporting activities, and the transplant had an estimated mean survival time of 12.6 years. These findings supported meniscus allograft transplantation as a viable surgical option for active patients with severe cartilage damage and missing or irreparable menisci.
SRF research showed that height, weight, and sex can help predict meniscal dimensions, providing tissue banks and surgeons with a faster, more cost-effective method for matching donor tissue to transplant recipients.
Accurate sizing is important because a transplanted meniscus must closely match the recipient’s anatomy. Traditional sizing methods rely on radiographs or MRI and can be difficult to apply consistently.
SRF found that these simple anthropometric measurements were correlated with meniscal size. The findings established a practical approach that can streamline donor-recipient matching for meniscus allograft transplantation.
The Meniscus Transplant Study Group brings together orthopaedic surgeons, scientists, and veterinary surgeons from around the world to share research, advance surgical techniques, and strengthen the clinical practice of meniscus transplantation. SRF supports and leads this collaboration as part of its broader meniscus research program. The 2026 MTSG meeting will be held on October 8 at the ICRS Summit in Porto, Portugal, with options to attend in person or virtually. Click below to learn more.
SRF tracks the outcomes of all patients undergoing meniscus transplantation at The Stone Clinic, using this long-term data to inform the field while continuing to explore new approaches and research collaborations in meniscus regeneration and transplantation.
Meet real patients who benefited from advances developed through SRF meniscus research, preserving their natural joints while regaining function and returning to high-level activity. Watch their stories of recovery and the journey back to active living.
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Dr. Kevin R. Stone
Meniscus transplantation has completely changed our perception of knee arthritis and how to treat it. In the past when a person would get arthritis, there would be wearing away of the articular cartilage. Very commonly that occurs when an athlete has torn their meniscus and a surgeon removed part of it. Over the years, the patient wears away the articular cartilage. Now we can replace that meniscus and prevent the progression to severe arthritis.
Surgical technique for medial meniscus allograft transplantation.
View Full DetailsStep-by-step lateral meniscus allograft transplantation technique.
View Full DetailsShowing 7 of 7 studies
Kevin R. Stone, Ann W. Walgenbach
Research Question: How can meniscus allograft fixation be improved?
An improved arthroscopic technique of meniscal transplantation that simplifies the surgical procedure and secures the allograft to the tibia at 3 sites.
Key Finding: Improved arthroscopic technique securing allograft to tibia at 3 sites.
Kevin R. Stone, Ann W. Walgenbach, Thomas J. Turek, Abhi Freyer, Martin D. Hill
Research Question: Should patients with arthritis be excluded from meniscus transplantation?
Meniscus allografts can survive in a joint with arthrosis, challenging the contraindications of age and arthrosis severity.
Key Finding: 89.4% allograft survival rate in arthritic knees—challenging conventional contraindications of age and arthrosis.
Kevin R. Stone, Abhi Freyer, Thomas J. Turek, Ann W. Walgenbach, Sonali Wadhwa, John V. Crues III
Research Question: How can surgeons accurately match meniscus allografts to patients?
Height, weight, and gender should be considered by both tissue banks and surgeons as fast and cost-effective variables by which to predict meniscal dimensions.
Key Finding: Height, weight, and gender correlate with meniscal dimensions—simplifying tissue bank matching protocols.
Kevin R. Stone, Ann W. Walgenbach, Abhi Freyer
Research Question: Can meniscus transplants succeed in knees that already have arthritis?
Meniscus transplantation is a rewarding soft tissue reconstruction that can be useful for arthritic as well as pristine knees to alleviate pain, restore function, and ultimately, delay or avoid joint arthroplasty.
Key Finding: Comprehensive review demonstrating allografts can survive in arthritic knees and delay joint replacement.
Kevin R. Stone, Johnathan R. Pelsis, Wendy S. Adelson, Ann W. Walgenbach
Research Question: Is it possible to rebuild meniscus cartilage that has been lost?
Meniscus reconstruction techniques offer new possibilities for rebuilding meniscus cartilage in patients who have lost this critical structure.
Key Finding: Meniscus reconstruction represents a new paradigm for rebuilding damaged meniscus cartilage.
Kevin R. Stone, Wendy S. Adelson, Johnathan R. Pelsis, Ann W. Walgenbach, Thomas J. Turek
Research Question: Can meniscus transplant and cartilage repair be performed together successfully?
Combined meniscus allograft transplantation with articular cartilage repair procedures demonstrates excellent long-term survival and functional outcomes.
Key Finding: Concurrent meniscus allograft transplantation and articular cartilage repair provides long-term joint preservation.
Kevin R. Stone, Ann W. Walgenbach, Shadera Slatter, Thomas J. Turek, Caroline Ferguson-Dryden, Marie Dicker, Emma Miltenberger, Haley Cowles, Vivian Liu, Stephanie Wu, Mani Vessal
Research Question: Can meniscus allograft transplantation delay or prevent knee replacement in older patients?
Meniscus allograft transplantation in conjunction with biologic knee restoration procedures can effectively delay or prevent the need for total knee replacement in patients older than 50 years.
Key Finding: Meniscus allograft transplantation with biologic knee restoration improved pain and function in patients over 50 years old. Patients who progressed to knee replacement delayed the need for one by a mean time of 8.64 years.
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