Meniscus Allograft Transplantation

The meniscus plays a vital role in chondroprotection, shock absorption, load distribution, proprioception, joint lubrication, and secondary stabilization. If a patient with meniscal deficiency becomes symptomatic, meniscal allograft transplantation (MAT) is one surgical option. Understanding the unique anatomic and biomechanical characteristics of the medial and lateral meniscus is essential when considering a meniscal transplantation. MAT is currently indicated for younger (up to age 50) symptomatic patients with meniscal deficiency following previous subtotal or functional meniscectomy. Surgeons must also correct any concomitant pathology, such as high-grade cartilage defects, ligament insufficiency, and limb malalignment, as failure to correct these comorbidities leads to less optimal outcomes and are often associated with early transplant failure. Each of the three standard MAT techniques will be discussed in detail: bone plug, bone bridge-in-channel (e.g., slot, trough, dovetail, keyhole, etc.), and soft tissue only fixation.