Authors’ Disclosure Statement: The authors report no actual or potential conflict of interest in relation to this article.
Mr. Gitelis and Mr. Meyer are Medical Students, Dr. Frank and Dr. Cvetanovich are Orthopaedic Surgeons, and Dr. Cole is a Professor and Orthopedic Surgeon, Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois.
Address correspondence to: Brian J. Cole, MD, Department of Orthopaedic Surgery, Rush University Medical, 1611 West Harrison Street, Suite 300, Chicago, IL 60612 (email, brian.cole@rushortho.com).
Matthew E. Gitelis, BS Rachel M. Frank, MD Maximillian A. Meyer, BSGregory Cvetanovich, MD Brian J. Cole, MD, MBA . 5 Points on Meniscal Allograft Transplantation. Am J Orthop.
September 4, 2018
TAKE-HOME POINTS
Patient selection is critical for obtaining long-term functional outcome improvements and reduced pain, with the ideal MAT candidate being a chronologically and physiologically young patient (<50 years) with symptomatic meniscal deficiency.
Existing pathology in the knee needs to be carefully considered and issues such as malalignment, cartilage defects, and/or ligamentous instability may require a staged or concomitant procedure.
Accurate graft width and length measurements are vital, and the most common technique used today includes measuring the meniscus on anteroposterior and lateral radiographic images.
When preparing the graft for the bone-bridge technique, the bone is fashioned to create a bone bridge 10 mm in depth by approximately 7 mm in width, incorporating the anterior and posterior horns of the meniscus.
Graft fixation can be accomplished by placing vertical mattress sutures and tying those down with the knee in full extension.
References
ABSTRACT
Meniscus allograft transplantation (MAT) has yielded excellent long-term functional outcomes when performed in properly indicated patients. When evaluating a patient for potential MAT, it is imperative to evaluate past medical history and past surgical procedures. The ideal MAT candidate is a chronologically and physiologically young patient (<50 years) with symptomatic meniscal deficiency. Existing pathology in the knee needs to be carefully considered and issues such as malalignment, cartilage defects, and/or ligamentous instability may require a staged or concomitant procedure. Once an ideal candidate is identified, graft selection and preparation are critical steps to ensure a proper fit and long-term viability of the meniscus. When selecting the graft, accurate measurements must be taken, and this is most commonly performed using plain radiographs for this. Graft fixation can be accomplished by placing vertical mattress sutures and tying those down with the knee in full extension.
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