Meniscus Transplants

Treatment options are limited in patients reporting knee pain isolated to either the medial or lateral compartment following subtotal meniscectomy or partial meniscectomy with deficient remaining tissue. In appropriately selected patients, determined based on a detailed and thorough history, physical examination, and evaluation of imaging, meniscal allograft transplantation (MAT) offers an acceptable treatment solution in younger patients and those in which arthroplasty is not indicated. MAT may be combined concurrently or performed in a staged fashion to correct lower extremity malalignment, focal chondral defects, and ligamentous insufficiency. Both soft tissue and bony fixation techniques have been reported during MAT, with the bridge-in-slot technique being the preferred technique of the senior author. Despite largely heterogeneous outcomes reporting in the literature, MAT has been shown to improve pain and function at both mid- and long-term follow-up. However, in patients with preexisting chondral degeneration, MAT does not cease the progression of osteoarthritis. The purpose of this chapter is to provide a concise overview, supported by data in the current literature, on the indications, patient evaluation, preoperative assessment, preparation, and preferred surgical technique of the senior author. Commonly encountered complications and an overview of the senior author’s rehabilitation protocol are also reviewed, in addition to a summary of current outcomes following MAT.