Technical innovation: creation of a peripheral vascularized trough to enhance healing in cryopreserved meniscal allograft reconstruction

The important functions of the meniscus have been well described. Lack of a meniscus may lead to instability and early osteoarthrosis of the knee. Meniscal transplantation is an option following complete or subtotal meniscectomy in symptomatic patients with correct alignment, and mild to moderate chondrosis with the goal of preventing further degenerative sequelae to the knee. Since the first meniscus allograft implantation was performed 1984, there have been reported several open and arthroscopic techniques. We present our technique of arthroscopically assisted transplantation of a cryopreserved meniscal allograft with special consideration given to the technical details of this procedure. This technique employs creation of a circumferential osseo-cancellous trough in combination with transosseous tibial tunnel fixation and arthroscopic suture passage to both secure and enhance healing of the meniscal allograft.