Innovative Techniques for Complex Meniscal Repair, Substitution, and Meniscal Allograft Transplantation (AANA19)-Innovative Techniques for Meniscus Allograft Transplantation-Dr. Seth L. Sherman, M.D.

Innovative Techniques for Meniscus Allograft Transplantation-Dr. Seth L. Sherman, M.D.

Video Transcription

Video Summary

The lecture covers meniscus transplantation and substitution as surgical options for symptomatic meniscus deficiency aimed at restoring knee biomechanics, reducing pain, and improving function. Medial and lateral menisci differ anatomically and biomechanically; medial meniscectomy is better tolerated than lateral, which often requires concomitant cartilage restoration. Patient selection, managing expectations, precise graft sizing (within 10% of native meniscus), and preoperative planning are critical. Techniques include bone plug and bone bridge fixation, with suspensory cortical fixation favored for strength and stability. Meniscal extrusion, though common especially laterally and with soft tissue grafts, lacks consensus on clinical impact. Rehabilitation protocols vary and require further study. Meniscus transplants improve pain and function in 80% of cases but do not prevent osteoarthritis progression and have a ~10% complication rate. Absolute contraindications include advanced arthritis and inflammatory conditions. Overall, treating the joint as an organ—addressing alignment, stability, meniscus, and cartilage—is essential for successful outcomes.

Asset Caption

Instructional Course Lecture: Innovative Techniques for Complex Meniscal Repair, Substitution, and Meniscal Allograft Transplantation

Keywords

meniscus transplantation

meniscus substitution

knee biomechanics

meniscectomy

graft fixation techniques

meniscal extrusion