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

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.