Arthroscopic Meniscal Transplantation Technique

The meniscus provide several important mechanical functions in the knee joint. Following menisectomy the tibiofemoral contact area decreases while the contact forces increase. Meniscal allograft transplantation (MAT) offers the potential to restore partial load-bearing, decrease symptoms, and provide chondroprotective effect. Ideal patient for MAT should have normal alignment, stable knee, abscence of cartilage damage and has less than 50 years-old. Several open and arthroscopic MAT techniques have been described. The succesful of MAT is to use a minimal invasive technique without sacrificing the precise anatomic reconstruction of the original meniscofemoaral and meniscotibial relationships. Anatatomical position, appropriate sizing of the graft, and fixation method are crucial key points to have good results. In general there are three fixation methods: soft tissue fixation, suture fixation through transoseous tunnels, and bone plugs press-fit fixation. However, inferior biomechanical and contact pressure have been reported with soft tissue and transosseous tunnels compared with the bone block technique.