A modified keyhole technique for minimizing size mismatches during a smaller than optimal lateral meniscal allograft...

Despite careful preoperative and intraoperative sizing of lateral menisci in recipient knees, size mismatches between allografts and recipient menisci are often encountered. To minimize size mismatches during the transplantation of smaller than expected lateral meniscal allografts, we devised a modified keyhole technique by dividing the central bone bridge into 2 bony fragments. The fragments are attached to the anterior and posterior horns. In the event of mismatch, the anterior bony fragment is moved anteriorly in the keyhole tunnel. Although the technique of meniscal transplantation is technically demanding, the central bone bridge can be divided without difficulty. The described technique is considered a useful alternative method during lateral meniscal transplantation.