Greater Axial Trough Obliquity Increases the Risk of Graft Extrusion in Lateral Meniscus Allograft Transplantation

Abstract

The risk of graft extrusion increases as the axial plane trough angle increases. The angle can be reduced by ensuring that the bony trough starting point is not created in too lateral a position.

Lateral Capsular Fixation: An Implant-Free Technique to Prevent Meniscal Allograft Extrusion

“…Other studies showed that in the bone bridge technique, the risk of graft extrusion increases as the angle of the trough on the axial plane increases. 16 Jeon et al 17 suggested that the excision of a peripheral osteophyte larger than 2 mm in the proximal tibial plateau was associated with less MAT extrusion. Some surgeons fix the meniscus body to the tibial plateau in an attempt to control graft extrusion.…”

Effect of Sagittal Allograft Position on Coronal Extrusion in Lateral Meniscus Allograft Transplantation

“…17 However, the 3 aforementioned studies overlooked the anatomic graft position on the sagittal plane. [15][16][17] To our knowledge, our study is the first to measure sagittal graft position after MRI obtained immediately after lateral MAT.…”

“…17 However, the 3 aforementioned studies overlooked the anatomic graft position on the sagittal plane. [15][16][17] To our knowledge, our study is the first to measure sagittal graft position after MRI obtained immediately after lateral MAT. The results showed that the anterior horn position was more extruded from the anterior tibial articular margin and that the posterior horn position was more intruded from the posterior tibial articular margin in the lateral MAT group than in the control group, indicating that the position of the allograft was more anterior than the normal lateral meniscus.…”

“…15,16 These studies, however, focused on the coronal or axial position of the bony trough, as well as the anterior and posterior horns. [15][16][17] To our knowledge, graft extrusion on the sagittal plane has never been investigated, and the relations between the sagittal position of the bony trough and the horns and graft extrusion on the coronal plane are unclear.…”

Intraoperative Templating in Lateral Meniscal Allograft Transplantation

“…Therefore, during every surgical step of the meniscal allograft transplantation, our best efforts have to be focused on prevention of extrusion of the meniscal allograft. Recently published articles emphasized the importance of anatomical placement of the lateral meniscal allograft to decrease postoperative extrusion 56). Here, we present a patient who underwent a lateral meniscal transplantation using a wire that was formed to the contour of the allograft for correct graft placement.…”