Meniscus allograft transplantation

Abstract

Reports of transplantation of the meniscus date back to the early 1900s, but transplantation only more recently became a viable treatment option for select patients. Young patients with persistent pain following total or near-total meniscectomy, with absence of other ligamentous or cartilage pathology, are considered good candidates for meniscal transplantation. A commonly used method of determining allograft size is derived from a regression model that uses height, weight, and gender variables. There are a number of well-described surgical techniques for meniscal allograft transplantation described. Our institution's preferred technique involves utilization of an entirely soft tissue graft with fixation of the posterior horn via transtibial suture, peripherally via a combination of various meniscal suture techniques and devices and the anterior horn via PushLock anchor. Malalignment, ligamentous instability, and/or articular cartilage pathology should be addressed prior to or at the time of MAT. Although challenging to interpret the literature as whole in regard to the success of meniscal allograft transplantation, the overwhelming majority of reports demonstrate success of the procedure in terms of patient reported outcome measures. As a result of this success, meniscal allograft transplantation appears to be becoming increasingly utilized for selected patients with symptomatic lack of a meniscus.