Meniscal Allograft Transplantation With Hybrid Fixation to Optimize Graft Tension: A Surgical Technique

Meniscal allograft transplantation is an established procedure for restoring knee joint biomechanics and potentially delaying osteoarthritis progression in symptomatic, meniscus-deficient patients. This Technical Note describes an arthroscopic meniscal allograft transplantation approach using a posterior root bone plug and anterior root soft tissue fixation. This hybrid fixation technique is designed to produce stable root fixation while allowing adjustment of the graft position to accommodate minor graft/recipient size mismatch. The surgical technique involves graft preparation, knee arthroscopy with removal of residual meniscus, posterior and anterior root fixation via independent transtibial tunnels, and circumferential fixation using a combination of all-inside and inside-out sutures.