Arthroscopically assisted meniscal allograft transplantation

Meniscal allograft transplantation (MAT) is performed in the United States in ever-increasing numbers. Various techniques have been described since the initial transplantation was performed more then 20 years ago. Decreased pain and improved knee function are attainable with proper patient selection, identification, and correction of all concomitant malalignment and instability, and intervention earlier in the disease process. This article reviews the indications for MAT and offers a basic treatment algorithm for managing concomitant cartilage lesions, instability, and misalignment. The author's preferred arthroscopic technique using individual bone plugs for both medial and lateral MAT and fresh-frozen allograft is described. This technique stresses the low morbidity of the approach and the re-establishment of the anatomic bony attachments of the anterior and posterior horns of the meniscus.