Allograft meniscus transplantation

Abstract

Menisci function to manage load transmission, provide secondary mechanical stability as well as nutrition, and lubricate the joint. Meniscus transplantation techniques continue to evolve and include: free soft tissue allograft implantation; separate anterior and posterior bone plugs; and bone bridges including key hole, trough, dovetail, and bridge-in-slot variations. The senior author's preference is for the bridge-in-slot technique for lateral and medial menisci, owing to its simplicity and secure bony fixation, flexibility in allowing concomitant procedures as osteotomy and ligament reconstruction, and the ability to maintain the native anterior and posterior meniscal horn attachments. Meniscal allograft transplantation yields fair to excellent results in almost 85% of patients. Patients demonstrate significant decrease in pain, as well as an increase in activity. Long-term success is encouraging in well-selected patients but is unknown whether transplantation is protective against the progression of degenerative changes.