Meniscal Transplant using Autologous Semitendinosus Tendon Leads to Clinically Meaningful Quality of Life Improvement: A Case Report.

BACKGROUND: The detrimental consequences of untreated meniscal tears or total meniscectomy, including impaired rotatory stability, increased sagittal laxity, and accelerated cartilage degeneration, are well documented, even though meniscectomy is still the most commonly performed procedure. Meniscus allograft transplantation remains the gold standard for meniscal substitution; however, its limited availability highlights the need for safe and effective autologous alternatives. Emerging evidence supports the use of autologous tendon grafts, particularly the semitendinosus tendon, as promising biological substitutes, offering a viable solution to allografts and synthetic implants.

CASE REPORT: A 39-year-old woman presented with lateral knee pain and swelling, 29 years after undergoing a subtotal lateral meniscectomy at age 10. Clinical examination revealed lateral joint line tenderness and a range of motion (ROM) of 0°-120°. Radiographs and magnetic resonance imaging showed degenerative changes in the residual lateral meniscus, cartilage defects in the lateral compartment, and intra-articular loose bodies. Following initial arthroscopy and persistent symptoms, a lateral meniscus autograft transplantation using a hamstring tendon was performed. Post-operative rehabilitation included a progressive ROM limitation: 0°-30° (weeks 0-3), 0°-60° (weeks 3-6), and 0°-90° (weeks 6-8). Partial weight-bearing was allowed for 4 weeks, progressing to full weight-bearing at 8 weeks; squatting was restricted for 4 months. Jogging was initiated at 3 months, with return to sport at 6 months. At 1-year follow-up, the patient was asymptomatic with a 15° gain in flexion and significant improvement in all functional scores (Lysholm score, International Knee Documentation Committee score, and Knee Injury and Osteoarthritis Outcome Score).

CONCLUSION: This case supports the growing evidence that, with careful surgical planning and appropriate patient selection, autologous tendon grafts represent a viable biological option for meniscal reconstruction. This approach may be particularly beneficial in middle-aged patients, in whom joint preservation remains a key therapeutic goal.