Meniscus Deficiency and Meniscal Transplants

Meniscus deficiency is a common cause of knee pain, disability, and early-onset osteoarthritis, generating a significant burden on society. Causes of meniscus deficiency include previous subtotal or total meniscectomy and a functional loss caused by an irreparable root tear or deep radial tear. Meniscal allograft transplantation (MAT) is an established surgical procedure for select young patients with refractory unicompartmental pain associated with meniscal deficiency. MAT may also be beneficial for meniscal-deficient patients undergoing revision anterior cruciate ligament reconstruction for recurrent instability or in the settings of an articular cartilage repair procedure in the ipsilateral compartment. Predictable improvement in patient-reported outcomes and reduction of pain is expected after MAT when strict patient selection criteria is adhered to and when concomitant pathological conditions are appropriately addressed. However, graft survival time and reoperation rates are still not ideal and warrant informed preoperative discussion with the patient to match expectations. As our understanding of patient selection, graft preparation and surgical techniques continue to develop, we expect MAT outcomes to continue to improve.