Dr. Goble was first introduced to MAT in 1990 when a colleague, Dr. John Garrett of Atlanta Georgia, consulted with Dr. Goble in the possible development of a standard surgical approach to replacement of a native meniscus by a donor meniscus. Conceptually, there were would be many advantages of meniscal transplantation over knee replacement – if a practical and reliable procedure could be developed. A new transplanted meniscus would rejuvenate and protect an otherwise healthy knee joint. It would provide an alternative to a total knee procedure and avoid the limitations it imposes.
To that point, Dr. Garrett had pioneered early MAT transplantation by use of fresh cadaver harvest and transplantation, within 48 hours. However, Dr. Garrett was confronted with the practical difficulty of using fresh meniscal tissue because of issues concerning supply, sizing, disease transmission, and cost.
Dr. Garret presented his early research and development to a group of knee surgeons: Doctors Wjoyts, Stone and Wolf. They accepted the challenge and began their own efforts to develop a practical MAT procedure.
Over the next 10 years, Dr. Goble implanted well over 100 Meniscal Allograft Transplantations. The surgical indications, allograft preparation, sizing, surgical technique and patient results are reported by Dr. Goble in these publications. The research and innovation performed by Doctors Goble, Wjoyts, Stone and Wolf resulted in an effective and practical MAT surgical procedure.
However, the MAT procedure is not widely offered by orthopedists who perform total knees for several reasons. First, the current Meniscal Allograft Transplantation procedure takes over 4 hours, and is very difficult for a surgeon to learn and perform. Second, it is relatively time consuming and expensive compared to alternatives. Last, insurance companies do not reimburse doctors who perform the surgery at a rate which makes the surgery cost effective for regular practice.
The MAT surgery works. For the proper patient it is a superior alternative to a total knee. Although only a few surgeons are trained to perform this procedure, it is available to the educated candidate.
Dr. Goble accepts candidates for Meniscal Allograft Transplantation after referral from a local doctor. He will also accept a candidate who is otherwise sufficiently informed about their options regarding the procedure.