All-Inside, All-Soft-Tissue, Anchor-Free Meniscal Allograft Transplantation

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomedical Engineering

Background:

• Meniscal allograft transplantation is a viable surgical option for irreparable meniscal pathology.
• Existing techniques may involve anchors, posing risks like displacement or failure.

Purpose of the Study:

• To describe a novel all-inside, anchor-free, all-soft-tissue arthroscopic technique for meniscal allograft transplantation.
• To emphasize the minimally invasive nature and reproducibility of the described method.

Main Methods:

• Utilized standard arthroscopic portals (anteromedial, anterolateral, mid-medial collateral ligament).
• Prepared the meniscocapsular junction and created tibial tunnels for meniscal roots.
• Employed meniscus-to-meniscus hand-tied sutures for graft fixation, avoiding anchors.
• Sequentially implanted the meniscal allograft from posterior to anterior.

Main Results:

• Achieved secure graft fixation without anchors, minimizing risks of anchor-related complications.
• Enabled precise graft adjustment for minor size mismatches.
• Facilitated simultaneous performance of concomitant procedures like ligament reconstruction or osteotomy.

Conclusions:

• The anchor-free, all-soft-tissue technique provides a reproducible and cost-effective alternative for meniscal allograft transplantation.
• This method ensures strong graft integration through continuous fixation to the native meniscocapsular junction and anatomic restoration of meniscal roots.
• The technique preserves minimal invasiveness while offering controlled tensioning and uniform graft compression.