Arthroscopic Medial Meniscus Replacement Using a Peroneus Longus Autograft: Surgical Technique

Medial meniscus deficiency is associated with progressive joint degeneration and impaired load distribution in the knee. While meniscus allograft transplantation is an established treatment for young and active patients, its accessibility is limited in many regions. This technical note describes a reproducible arthroscopic technique for medial meniscus replacement using an autograft harvested from the peroneus longus tendon. After subtotal meniscectomy, tibial tunnels are created at the native root attachment sites, and the graft is shaped and passed through the posterior tunnel. The graft is secured with an all-inside suture device and tensioned anteriorly. This method provides a biologically compatible and cost-effective alternative for meniscal reconstruction in patients without access to allograft tissue.