Lateral Meniscal Allograft Transplant via a Medial Approach Leads to Less Extrusion

Abstract

Based on this experience, lateral meniscal allograft transplant through a medial arthrotomy is preferred to decrease postoperative extrusion of the allograft.

Combined autologous chondrocyte implantation and meniscus reconstruction for large chondral defect in the lateral compartment due to discoid lateral meniscus tear: A case report

“…The use of a meniscal allograft implant for irreparable lateral meniscus has been reported [16]. Allografts are not widely used in Japan because institutional problems make implementation difficult.…”

Assessment of Anatomic Restoration and Clinical Outcomes Between Medial and Lateral Meniscal Allograft Transplantation

“…Extrusion of the meniscus, defined as the largest distance from the peripheral aspect of the meniscus to the border of the tibial plateau, was measured according to the method described by Verdonk et al 26 excluding any osteophytes on coronal MRI ( Figure 5F ). 4 The extruded distance of the meniscus beyond the outer margin of the tibial plateau was measured as the absolute value of extrusion. For standardization of individual knee size, the relative ratio of extrusion was calculated as the absolute value of extrusion divided by the entire width of the meniscus.…”

“…16,20 The different geometries of the medial and lateral menisci make the MAT technique different for each. 4,10,21 Medial MAT (MMAT) is generally performed using the bone plug technique, whereas lateral MAT (LMAT) is performed with a keyhole or trough technique, based on geometric characteristics. The nonanatomical transplantation in LMAT procedures increases the contact pressure and may eventually adversely affect the chondral surface.…”

Delayed Rehabilitation After Lateral Meniscal Allograft Transplantation Can Reduce Graft Extrusion Compared With Standard Rehabilitation

“…The axial trough angle on the axial plane between the line drawn along the long axis of the bony trough and another line perpendicular to the transposterior tibial condylar line was measured as previously reported. 1,6,33…”

“…1,7,18,19 Several surgical techniques to prevent meniscal extrusion after MAT exist, including graft size reduction, anatomic placement of the bony bridge, peripheral osteophyte excision, and lateral joint capsule stabilization. 6,7,18,19,33 However, studies on the rehabilitation strategy to minimize graft extrusion are lacking.…”