20Shoulder Care
AC Joint Injuries
Arthritis
Biceps Tendon Injuries
Calcific Tendinitis
Clavicle Fractures
Frozen Shoulder
Labral and SLAP Tears
Rotator Cuff Injuries
Shoulder Dislocation/Instability
Subacromial Impingement/Busitis
A-C Joint Stabilization
Biceps Tenodesis
Clavicle Fracture Fixation
Pectoralis Major Repair
Rotator Cuff Repair
Shoulder Instability Surgery – Bankart Repair
Shoulder Instability Surgery – Latarjet Procedure
Subacromial Decompression and Acromioplasty
Superior Capsular Reconstruction
Total Shoulder Replacement
28Knee Care
ACL Tear
Cartilage Injury
Lateral Meniscus Tear
LCL Injury
MCL Injury
Medial Meniscus Tear
Osteoarthritis
Patellar Instability
Patellofemoral Chondromalacia
Posterolateral Corner Injury
Trochlear Dysplasia
Anterior Cruciate Ligament (ACL) Reconstruction
Cartilage Restoration Surgery – Autologous Chondrocyte Implantation (ACI-Carticel)
Cartilage Restoration Surgery – Donor Graft
Collagen Meniscal Implant (CMI)
Lateral Collateral Ligament (LCL) Reconstruction
Medial Collateral Ligament (MCL) Reconstruction
Meniscus Repair
Meniscus Root Repair
Meniscal Transplant
Nanofracture
Osteochondral Allograft Transfer
Osteochondral Autograft Transfer (OATS)
Partial Meniscectomy
Posterior Cruciate Ligament (PCL) Reconstruction
Posterolateral Corner (PLC) Surgery
Tibial Tubercle Osteotomy
Trochleoplasty
17Hip Care
Cartilage Injury
Femoroacetabular Impingement (FAI)
Gluteal Tears
Hamstring Tears
Hip Instability
Labral Tears
Psoas Impingement (Internal Snapping Hip)
Trochanteric Bursitis
Acetabuloplasty
Chondroplasty
Femoroplasty
Gluteal Repair
Labral Debridement
Labral Repair
Labral Reconstruction
Nanofracture
Trochanteric Bursa Debridement
2Biologics
Bone Marrow Aspirate Stem Cell Concentrate (BMC)
Platelet-Rich Plasma “PRP”

MENISCAL TRANSPLANT

The meniscus is a pliable substance that sits between two bones in the knee joint, the femur (thigh bone) and tibia (shin bone). Some patients with meniscus tears can be treated with a combination of activity modification and a focused physical therapy program. Some patients who have had previous meniscus surgery may develop pain and instability due to limited functioning meniscal tissue. In such patients, Dr. Keller may recommend a meniscal transplant. A meniscal transplant involves transferring a healthy meniscus from a donor and securing it to the patient’s knee where the meniscus is deficient.

Dr. Keller prefers a “bone-plug” technique for meniscus transplantation. Prior to surgery, Dr. Keller measures the size of the deficient meniscus using x-rays and/or an MRI. A donor with a similar sized meniscus is identified and the tissue is cleaned and prepared appropriately prior to surgery. During surgery, Dr. Keller positions the donor graft in the knee and secures the bone part of the graft to the tibia bone with a medical screw (interference screw). Next, Dr. Keller uses a suture-passing device to attach stitches form the donor meniscus to the capsule (a soft tissue pouch that surrounds the knee). The stitches are then secured with square knots. These stitches help stabilize the meniscus and keep the meniscus in the appropriate position during the healing phase.

Post-Operative Rehabilitation

Following surgery, patients are placed in a hinged brace that is locked straight. Dr. Keller recommends partial weight bearing for 4-6 weeks in the brace. When the patient is sitting or lying down, Dr. Keller encourages knee range of motion from 0-90 degrees with the brace removed for the first few weeks after surgery. Dr. Keller also recommends intermittent icing and straight leg raise exercises to strengthen the quadriceps muscles. Dr. Keller recommends starting physical therapy two weeks after surgery. Physical therapy focuses on reducing swelling in the knee, restoring full range of motion, and eventually, restoring strength to the knee. Most patients can start full weight bearing on the affected leg 4-6 weeks after surgery. Most patients start cutting activities and sporting activity approximately 4-6 months after surgery.