Treatment of Failed Lateral Meniscal Oblique Radial Tear Repair With Segmental Allograft Meniscus Transplantation

Surgical techniques that preserve the native meniscus have been investigated in the setting of irreparable meniscal tears, including meniscal allograft transplantation (MAT) and meniscal synthetic scaffolds. Complete MAT removes the entirety of the native meniscal tissue for transplantation with suboptimal long-term survivorship. Similarly, synthetic meniscal scaffolds have shown variable success rates with an inability to regenerate functional tissue or prevent early osteoarthritis. Therefore, segmental MAT techniques have been explored to preserve the healthy, native meniscal biology and decrease knee contact pressures and total surface contact area. Current indications for segmental MAT continue to evolve but may be considered in near-complete or full-thickness segmental meniscal deficiency, generally 1 to 2.5 cm in total meniscal length. Typically, the segmental deficiency is in the posterior or posterior-middle junction of the meniscus. This technique article outlines an arthroscopic technique for lateral segmental meniscal transplantation for an irreparable lateral meniscal oblique radial tear of the posterior horn with a 20-mm segmental defect.