Meniscal Allograft Transplantation With Soft-Tissue Fixation Including the Anterior Intermeniscal Ligament

Abstract

Meniscal allograft transplantation has been introduced as a treatment for symptomatic meniscus-deficient patients to improve clinical outcomes. We describe an arthroscopic technique for meniscal allograft with soft-tissue fixation including the anterior intermeniscal ligament (AIML): arthroscopic double soft-tissue fixation technique. The AIML and anterior and posterior roots are detached and sutured using running locked Krackow stitches. After preparation of the meniscal bed, the meniscus is passed into the knee and the posterior meniscal horn is fixed with sutures through bone tunnels. The body of the meniscus is fixed with all-inside sutures. Then, the anterior meniscal suture is fixed on the anatomic point of the anterior root with an anchor. The AIML suture is fixed with an anchor to the bare area of the proximal tibia, anterior to the anterior cruciate ligament insertion. This reliable and reproducible technique is less complex than bone plug methods; it is less invasive but still provides stable and secure graft fixation. It will help surgeons to improve clinical results and to limit early secondary extrusion of the graft.

Medial Meniscal Allograft Transplantation With Bone Plugs Using a 3-Tunnel Technique

“…12 The difference may be due to a higher degree of meniscal extrusion with soft-tissue fixation as compared with bone plug fixation, as reported by Abat et al 13 in 2012. However, we acknowledge that clinical differences between bone plug and soft-tissue fixation have not been proved, and Kim et al 14 suggested that soft-tissue fixation can still be stable and secure enough to limit secondary graft extrusion.…”

Fully Guided Synthetic Osteochondral Resurfacing of a Large Stifle OCD Lesion Using a Patient-Specific Implant and Drill Guides

“…Future applications should investigate transosseous suture fixation, bone anchors or bone plug fixation, which seems to be the most efficient fixation method. 25,26 At the 18-month radiographic follow-up, stable fixation of the PSI with evidence of bony incorporation was present. Previous studies in a sheep model using similar implants showed bone-to-implant contact already at 6 months.…”

All-Arthroscopic Meniscal Allograft Transplantation Technique with Bone Plugs and Preloaded Sutures

“…Despite that, Kim et al. 24 suggest that MAT with soft tissue is less complex and can still provide stable and secure graft fixation.…”

“…According to Abat et al, 23 the suture-only fixation technique also leads to a higher degree of extrusion than bony fixation in MAT. Despite that, Kim et al 24 suggest that MAT with soft tissue is less complex and can still provide stable and secure graft fixation.…”