Meniscal transplant combined with anterior cruciate ligament reconstruction

The meniscal cartilage plays a vital role in maintaining normal knee function. This important structure provides shock absorption, stabilization, lubrication, proprioception, and load sharing to the knee joint. Although it has been shown that an anterior cruciate ligament (ACL) reconstruction can provide symptomatic pain relief in the arthritic knee, the results following ACL reconstruction in a medial meniscus-deficient knee are usually worse than when the medial meniscus is intact. Given these findings, meniscal allograft transplantation with concomitant ACL reconstruction have been performed to provide patients with a more stable and functional knee as well as to forestall the degenerative process. We report our indications, preoperative considerations, surgical technique, postoperative rehabilitation protocol, and results with meniscal allograft transplantation combined with ACL reconstruction. We believe that meniscal transplantation combined with ACL reconstruction, in appropriately selected patients with meniscus- and ACL-deficient knees, offers significant advantages that cannot be accomplished with either procedure alone. Although technically challenging, careful attention to the details outlined will help to avoid pitfalls and will maximize the opportunity for a successful outcome. Our results suggest that this procedure can predictably improve subjective measures of function and symptoms while objectively restoring stability and affording protection to the articular surfaces of the transplanted knee compartment.