Lateral Meniscal Allograft Transplant: Dovetail Bone Bridge Preparation

Abstract

Meniscal tears are among the most common knee injuries encountered by an orthopaedic surgeon. Once treated with total meniscectomy, meniscal preservation is now the standard of care. Not all meniscal tears are repairable, and meniscal allograft transplantation has become an integral part of the preservation algorithm. This procedure is often recommended in a young active patient with healthy articular cartilage who has undergone a previous subtotal or total meniscectomy. There are many surgical methods for meniscal allograft transplantation, and the bone bridge technique has shown good improvement in outcome scores and good long-term survival. We describe our preferred technique for preparation of the dovetail bone bridge meniscal allograft for lateral meniscal allograft transplantation.

Fig 1

Tthe marking of the anterior horn of the lateral meniscal allograft with an “A” for anterior and the posterior horn with a “P” for posterior (arrows) to ensure proper orientation during preparation of the dovetail bone bridge technique.

Fig 2

The marking of the lateral meniscal allograft with the trapezoidal guide (arrow) to ensure proper orientation of the graft during preparation of the dovetail bone bridge technique.

Fig 3

The lateral meniscal allograft positioned within the holding posts of the meniscal workstation (arrow) during preparation of the dovetail bone bridge technique.

Fig 4

The lateral meniscal allograft after the bone cuts with a suture (arrow) holding meniscus during preparation of the dovetail bone bridge technique.

Fig 5

The lateral meniscal allograft within the meniscal graft sizing block (arrow) with a suture holding meniscus during preparation of the dovetail bone bridge technique.