New Cartilage Saves Knee in Trouble
December 14, 2009
Danbury NewsTimes - There was never a pop or a tear or the electric shock of excruciating pain. But Erin Olivo began to notice that after a day's walking or exercising, her left knee hurt. "I always had knee pain,'' she said "I always dealt with it. I played softball in high school,'' the New Fairfield native said. "When my knee began to hurt, I just thought I was out of shape.''
In fact, Olivo, now 22 and a student at Western Connecticut State University in Danbury, had a severely bangedup
meniscus -- the pad of cartilage that acts as a cushion between the ball and socket of the knee.
When Dr. Ross Henshaw, an orthopedic surgeon with Danbury Hospital's sports medicine department, operated
on her knee, he ended up removing the entire meniscus.
"It had flopped over on itself like a taco,'' he said. "It had lots of scar tissue.''
You can live comfortably without a meniscus -- for a while. But eventually, Henshaw said, the hard cartilage that
lines and covers the ball and socket of the knee will wear away. Then you get bone rubbing on bone and painful
arthritis.
"For people in their 40s or 50s, removing the meniscus would probably lead to knee replacement surgery in their
60s. That way they'd probably outlive their replacement parts, which last 25 years or more.
But with Olivo -- a beauty pageant contestant, member of WestConn's Humanitarian Travel Club, and secondary
education major who wants to teach history, --the choice was much tougher.
Without her meniscus, Henshaw said, the likelihood is sometime in her 30s her knee would really hurt. Then she
could have a knee replacement, knowing she'd probably need another in her 50s. Or she could live in pain for 20
years.
Instead, Hensahw offered Olivo another option. In October, he performed a meniscus transplant, inserting
meniscus cartilage harvested from an organ donor into Olivo's knee. It was the first time anyone had done the
operation at Danbury Hospital.
Now, more than two months later, Olivo said she will celebrate her birthday this month by abandoning her cane.
While she'll never play hard-core, knee-rattling sports again, she has a chance of living for a long time in comfort.
"I'll be ready to travel this summer,'' she said.
Henshaw said meniscus transplants are relatively rare, simply because the patients who are the best candidates
for them have to be like Olivo -- young, active, under 35, with healthy ligaments and healthy cartilage lining her
knee.
"For those who need it, it's a valuable, reliable, successful procedure,'' he said.
To do the operation, Henshaw had to carefully X-ray Olivo's left knee to get a complete set of measurements of
the bones. He then sent the measurements to a bone bank and waited until the bank had a meniscus that fit
Olivo --a wait that took about two months.
"When you become an organ donor, doctors can harvest almost everything they can -- from your eyes down to
your toes,'' Henshaw said.
The operation to fit Olivo with her new meniscus took about three hours. It was, Henshaw said, like cabinetmaking--first precisely cutting a slot in the bones of Olivo's knee, then carefully fitting the meniscus into that
slot, then sewing it into place.
For the first six weeks of her recovery, Olivo walked on crutches and wore a heavy brace on her knee, removing it
only to do physical therapy. She progressed from there to the cane. By this week she won't even need that.
Henshaw said she'll have to treat the knee gingerly for a while, until her body tissues begin to grow around the
meniscus. Because cartilage is acellular material, without blood flow, she won't need the anti-rejection drugs that
go with other organ transplants.
Henshaw said people with meniscus transplants will never be able to play sports that can tear up a knee --
basketball, soccer, singles tennis. But that leaves them a lot of things to do.
"It's not for an a high-performance athlete,'' he said. "It's to let you live an enjoyable life.''
And means Olivo will be able to compete in the event she's most geared up for -- the Miss Connecticut pageant.
In two previous runs, she's finished fourth runnerup, then third runnerup.
"Next year, I will be there,'' she said.
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