Segmental Meniscus Allograft Transplantation

Abstract

Meniscal tears treated with partial meniscectomies have been shown to significantly increase contract pressures within the tibiofemoral joint, and a complete focal meniscal deficiency may render the entirety of the meniscus functionally incompetent. Although various techniques of meniscal transplantation have been described, these techniques may require the excision of a considerable amount of healthy meniscal tissue. Furthermore, failures continue to frequently occur. Therefore, attempts to restoring normal knee kinematics and biomechanical forces are essential. Segmental meniscus allograft transplantations may offer the advantage of a robust repair by both maintaining knee biomechanics and biology while maximizing preservation of native meniscal tissue. Also, most meniscal deficiency involves only a portion of the meniscus, and thus we developed this technique to segmentally transplant only the deficient portion. The purpose of this Technical Note is to describe a technique of segmental medial meniscus allograft transplantation in a patient with focal medial meniscus deficiency.

Implantation of Novel Meniscus Scaffold for Irreparable Meniscal Tear

“… 10 The use of segmental meniscus allografts has also been recently reported after partial meniscectomy. 11 Limitations of allografts, however, include insufficient recellularization of the native meniscus and inferior stiffness of the graft. 12 Meniscal scaffolds provide an attractive alternative to allografts in terms of immunogenicity, infection, and effective reconstruction of the native size of the meniscus.…”

Medial Meniscal Allograft Transplantation With Bone Plugs Using a 3-Tunnel Technique

“…MAT has developed rapidly since it was first described, and a growing pool of evidence supports its efficacy, safety, and survivability. [3][4][5][6][7]9 Compared with the technique of MAT using 3 bone tunnels first described by Stone and Walgenbach 10 in 2003, several modifications have been made in the hope of improving patient outcomes. We use bone plug fixation in securing the anterior and posterior roots of the allograft.…”

“…[3][4][5] A variety of techniques for performing meniscal allograft transplantation (MAT) have been described in the literature, differing in the number of bone tunnels created, the placement of allograft, the method of root fixation, and even the amount of meniscus transplanted, among other variables. [6][7][8] This article details our technique of medial MAT using 3 bone tunnels and fixation via bone plugs.…”

Arthroscopic Segmental Medial Meniscus Allograft Transplant Using Three Fixation Techniques

“…Several surgical technique articles have been published describing various techniques for medial and lateral meniscus allograft transplantation. 23 , 24 , 25 , 26 , 27 While one other technique for segmental meniscus transplantation has been recently described, 28 this technique differs in that it employs a transtibial tunnel technique, which is familiar to most surgeons who perform meniscal root repairs and can be performed arthroscopically. The indications for segmental meniscus transplantation are narrow, as the posterior and anterior meniscus roots must be intact with a large portion of both posterior and anterior meniscus tissue preserved to allow for adequate fixation.…”