Medial Meniscal Allograft Transplantation: The Bone Plug Technique

Area of Science:

• Orthopedic surgery
• Biomedical engineering
• Sports medicine

Background:

• The menisci are crucial knee joint shock absorbers, converting axial load into hoop stresses.
• Meniscal deficiency disrupts these stresses, leading to degenerative changes and long-term joint problems.
• Meniscus allograft transplantation is a viable treatment for selective cases of meniscal deficiency.

Purpose of the Study:

• To describe a hybrid bone plug technique for meniscus allograft transplantation.
• To evaluate the efficacy and outcomes of this minimally invasive arthroscopic approach.

Main Methods:

• The surgical technique involves four steps: graft preparation, arthroscopic joint preparation, allograft attachment preparation, and graft fixation.
• A hybrid approach combines soft tissue and bone fixation techniques using a bone plug.
• The procedure is minimally invasive, utilizing arthroscopy without requiring a true arthrotomy.

Main Results:

• Meniscus allograft transplantation achieves good to excellent results in up to 85% of cases.
• Approximately 70% of patients experience improved pain and knee function at 10 years.
• Common complications include joint stiffness, early osteoarthritis, and graft failure, though midterm results are generally positive.

Conclusions:

• The described hybrid bone plug technique offers synergistic advantages, including good osseous integration.
• This minimally invasive arthroscopic approach simplifies a complex surgery.
• The technique yields excellent results for patients undergoing meniscus allograft transplantation.