Radiographic sizing for meniscal transplantation

Allograft or synthetic meniscal replacement has the potential to delay the arthritic sequelae of the meniscectomized knee. Meniscal implants must, however, be side and size specific. A cadaveric study was performed in which medial and lateral menisci were painted with a radiopaque tantalum powder-cyanoacrylic mixture. Radiographs of this preparation demonstrated reproducible relationships between each meniscus and established bony landmarks. When corrected for magnification, meniscal size could be derived from plain films. Meniscal width equaled the distance (coronal) from the peak of the tibial eminence to the periphery of the tibial metaphysis on anteroposterior films. Meniscal length was measured from lateral radiographs. Medial meniscal length was 80%, and lateral meniscal length was 70% of the measured sagittal length of the tibial plateau. Measurement error averaged 7.8% by these parameters.