Meniscal Injuries and Treatment in the Multiple Ligament Injured Knee

  • Michael A. DonohueEmail author
  • Matthew A. Posner
  • Adam M. Pickett
  • Chad A. Haley


Meniscus root repair and meniscus allograft transplantation are challenging procedures which provide the goal of restoration of knee kinematics and prevention of future knee osteoarthritis. In the setting of a multi-ligamentous knee injury or reconstruction, the long-term outcomes of either procedure are relatively unknown. A meniscus root repair can be essential to prevent increased strain on reconstructed cruciate ligaments as well as to normalize contact pressures within the tibiofemoral joint cartilage. While in the setting of meniscal allograft transplantation, important factors to consider include: alignment of the lower extremity, degree of cartilage wear based on the Outerbridge scale, and graft factors such as size, method of preservation, and fixation technique. Patient factors such as excessive body mass index and smoking may be relative contraindications. Staged procedures including osteotomy may be indicated to improve outcomes from meniscal transplantation. Both open and arthroscopic techniques can be used for both of the above procedures. Limited clinical evidence exists in the literature regarding outcomes for these combined procedures.


Meniscus Meniscus root Allograft Graft sizing Osteotomy Staged procedures Inside-out repair Rehabilitation Sub-total meniscectomy PCL injury 


  1. 1.
    Fairbank TJ. Knee joint changes after meniscectomy. J Bone Joint Surg Br. 1948;30B:664–70.PubMedCrossRefPubMedCentralGoogle Scholar
  2. 2.
    Fauno P, Nielsen AB. Arthroscopic partial meniscectomy: a long-term follow-up. Arthroscopy. 1992;8:345–9.PubMedCrossRefPubMedCentralGoogle Scholar
  3. 3.
    Milachowski KA, Weismeier K, Wirth CJ. Homologous meniscus transplantation. Experimental and clinical results. Int Orthop. 1989;13:1–11.PubMedCrossRefPubMedCentralGoogle Scholar
  4. 4.
    Lexer E. The classic. Joint transplantation (1908). Clin Orthop Relat Res. 1985:4–10.Google Scholar
  5. 5.
    Locht RC, Gross AE, Langer F. Late osteochondral allograft resurfacing for tibial plateau fractures. J Bone Joint Surg Am. 1984;66:328–35.PubMedCrossRefPubMedCentralGoogle Scholar
  6. 6.
    Canham W, Stanish W. A study of the biological behavior of the meniscus as a transplant in the medial compartment of a dog’s knee. Am J Sports Med. 1986;14:376–9.PubMedCrossRefPubMedCentralGoogle Scholar
  7. 7.
    McNickle AG, Wang VM, Shewman EF, Cole BJ, Williams JM. Performance of a sterile meniscal allograft in an ovine model. Clin Orthop Relat Res. 2009;467:1868–76.PubMedCrossRefPubMedCentralGoogle Scholar
  8. 8.
    Annandale T. Excision of the internal semilunar cartilage, resulting in perfect restoration of the joint-movements. Br Med J. 1889;1:291–2.PubMedPubMedCentralCrossRefGoogle Scholar
  9. 9.
    Allaire R, Muriuki M, Gilbertson L, Harner CD. Biomechanical consequences of a tear of the posterior root of the medial meniscus. Similar to total meniscectomy. J Bone Joint Surg Am. 2008;90:1922–31.PubMedCrossRefPubMedCentralGoogle Scholar
  10. 10.
    Bhatia S, LaPrade CM, Ellman MB, LaPrade RF. Meniscal root tears: significance, diagnosis, and treatment. Am J Sports Med. 2014;42:3016–30.PubMedCrossRefGoogle Scholar
  11. 11.
    LaPrade RF, LaPrade CM, James EW. Recent advances in posterior meniscal root repair techniques. J Am Acad Orthop Surg. 2015;23:71–6.PubMedCrossRefGoogle Scholar
  12. 12.
    Lerer DB, Umans HR, Hu MX, Jones MH. The role of meniscal root pathology and radial meniscal tear in medial meniscal extrusion. Skeletal Radiol. 2004;33:569–74.PubMedCrossRefGoogle Scholar
  13. 13.
    Padalecki JR, Jansson KS, Smith SD, et al. Biomechanical consequences of a complete radial tear adjacent to the medial meniscus posterior root attachment site: in situ pull-out repair restores derangement of joint mechanics. Am J Sports Med. 2014;42:699–707.PubMedCrossRefGoogle Scholar
  14. 14.
    Spang JT, Dang AB, Mazzocca A, et al. The effect of medial meniscectomy and meniscal allograft transplantation on knee and anterior cruciate ligament biomechanics. Arthroscopy. 2010;26:192–201.CrossRefGoogle Scholar
  15. 15.
    Baker BE, Peckham AC, Pupparo F, Sanborn JC. Review of meniscal injury and associated sports. Am J Sports Med. 1985;13:1–4.PubMedCrossRefGoogle Scholar
  16. 16.
    Greis PE, Bardana DD, Holmstrom MC, Burks RT. Meniscal injury: I. Basic science and evaluation. J Am Acad Orthop Surg. 2002;10:168–76.PubMedCrossRefGoogle Scholar
  17. 17.
    Hede A. Treatment of meniscal lesions in the knee. Epidemiological, clinical and experimental aspects. Dan Med Bull. 1993;40:317–31.Google Scholar
  18. 18.
    Hede A, Jensen DB, Blyme P, Sonne-Holm S. Epidemiology of meniscal lesions in the knee. 1,215 open operations in Copenhagen 1982-84. Acta Orthop Scand. 1990;61:435–7.PubMedCrossRefGoogle Scholar
  19. 19.
    Levy IM, Torzilli PA, Warren RF. The effect of medial meniscectomy on anterior-posterior motion of the knee. J Bone Joint Surg Am. 1982;64:883–8.PubMedCrossRefGoogle Scholar
  20. 20.
    Abdon P, Turner MS, Pettersson H, Lindstrand A, Stenstrom A, Swanson AJ. A long-term follow-up study of total meniscectomy in children. Clin Orthop Relat Res. 1990:166–70.Google Scholar
  21. 21.
    Krych AJ, Sousa PL, King AH, Engasser WM, Stuart MJ, Levy BA. Meniscal tears and articular cartilage damage in the dislocated knee. Knee Surg Sports Traumatol Arthrosc. 2015;23:3019–25.PubMedPubMedCentralCrossRefGoogle Scholar
  22. 22.
    Chung KS, Ha JK, Ra HJ, Kim JG. A meta-analysis of clinical and radiographic outcomes of posterior horn medial meniscus root repairs. Knee Surg Sports Traumatol Arthrosc. 2016;24:1455–68.PubMedCrossRefGoogle Scholar
  23. 23.
    Faucett SC, Geisler BP, Chahla J et al. Meniscus root repair vs meniscectomy or nonoperative management to prevent knee osteoarthritis after medial meniscus root tears: clinical and economic effectiveness. Am J Sports Med. 2018:363546518755754.Google Scholar
  24. 24.
    Matava MJ. Meniscal allograft transplantation: a systematic review. Clin Orthop Relat Res. 2007;455:142–57.PubMedCrossRefGoogle Scholar
  25. 25.
    Hergan D, Thut D, Sherman O, Day MS. Meniscal allograft transplantation. Arthroscopy. 2011;27:101–12.PubMedCrossRefGoogle Scholar
  26. 26.
    Accadbled F, Cassard X, Sales de Gauzy J, Cahuzac JP. Meniscal tears in children and adolescents: results of operative treatment. J Pediatr Orthop B. 2007;16:56–60.CrossRefGoogle Scholar
  27. 27.
    Bach BR Jr, Dennis M, Balin J, Hayden J. Arthroscopic meniscal repair: analysis of treatment failures. J Knee Surg. 2005;18:278–84.PubMedCrossRefGoogle Scholar
  28. 28.
    Cannon WD, Jr. Arthroscopic meniscal repair. Inside-out technique and results. Am J Knee Surg. 1996;9:137–43.Google Scholar
  29. 29.
    Kalliakmanis A, Zourntos S, Bousgas D, Nikolaou P. Comparison of arthroscopic meniscal repair results using 3 different meniscal repair devices in anterior cruciate ligament reconstruction patients. Arthroscopy. 2008;24:810–6.PubMedCrossRefGoogle Scholar
  30. 30.
    Lohmander LS, Roos H. Knee ligament injury, surgery and osteoarthrosis. Truth or consequences? Acta Orthop Scand. 1994;65:605–9.PubMedCrossRefPubMedCentralGoogle Scholar
  31. 31.
    Roos EM, Ostenberg A, Roos H, Ekdahl C, Lohmander LS. Long-term outcome of meniscectomy: symptoms, function, and performance tests in patients with or without radiographic osteoarthritis compared to matched controls. Osteoarthritis Cartilage. 2001;9:316–24.PubMedCrossRefPubMedCentralGoogle Scholar
  32. 32.
    Roos H, Lauren M, Adalberth T, Roos EM, Jonsson K, Lohmander LS. Knee osteoarthritis after meniscectomy: prevalence of radiographic changes after twenty-one years, compared with matched controls. Arthritis Rheum. 1998;41:687–93.PubMedCrossRefGoogle Scholar
  33. 33.
    Cheung HS. Distribution of type I, II, III and V in the pepsin solubilized collagens in bovine menisci. Connect Tissue Res. 1987;16:343–56.PubMedCrossRefPubMedCentralGoogle Scholar
  34. 34.
    McDevitt CA, Webber RJ. The ultrastructure and biochemistry of meniscal cartilage. Clin Orthop Relat Res. 1990:8–18.Google Scholar
  35. 35.
    Bullough PG, Munuera L, Murphy J, Weinstein AM. The strength of the menisci of the knee as it relates to their fine structure. J Bone Joint Surg Br. 1970;52:564–7.PubMedCrossRefGoogle Scholar
  36. 36.
    Walker PS, Erkman MJ. The role of the menisci in force transmission across the knee. Clin Orthop Relat Res. 1975:184–92.CrossRefGoogle Scholar
  37. 37.
    Shoemaker SC, Markolf KL. The role of the meniscus in the anterior-posterior stability of the loaded anterior cruciate-deficient knee. Effects of partial versus total excision. J Bone Joint Surg Am. 1986;68:71–9.CrossRefGoogle Scholar
  38. 38.
    Ferkel RD, Davis JR, Friedman MJ, et al. Arthroscopic partial medial meniscectomy: an analysis of unsatisfactory results. Arthroscopy. 1985;1:44–52.PubMedCrossRefGoogle Scholar
  39. 39.
    McGinity JB, Geuss LF, Marvin RA. Partial or total meniscectomy: a comparative analysis. J Bone Joint Surg Am. 1977;59:763–6.PubMedCrossRefPubMedCentralGoogle Scholar
  40. 40.
    Chatain F, Adeleine P, Chambat P, Neyret P, Societe Francaise dA. A comparative study of medial versus lateral arthroscopic partial meniscectomy on stable knees: 10-year minimum follow-up. Arthroscopy. 2003;19:842–49.CrossRefGoogle Scholar
  41. 41.
    Lee SJ, Aadalen KJ, Malaviya P, et al. Tibiofemoral contact mechanics after serial medial meniscectomies in the human cadaveric knee. Am J Sports Med. 2006;34:1334–44.PubMedCrossRefGoogle Scholar
  42. 42.
    Baratz ME, Fu FH, Mengato R. Meniscal tears: the effect of meniscectomy and of repair on intraarticular contact areas and stress in the human knee. A preliminary report. Am J Sports Med. 1986;14:270–75.PubMedCrossRefGoogle Scholar
  43. 43.
    De Smet AA, Blankenbaker DG, Kijowski R, Graf BK, Shinki K. MR diagnosis of posterior root tears of the lateral meniscus using arthroscopy as the reference standard. AJR Am J Roentgenol. 2009;192:480–6.PubMedCrossRefGoogle Scholar
  44. 44.
    LaPrade RF, Ho CP, James E, Crespo B, LaPrade CM, Matheny LM. Diagnostic accuracy of 3.0 T magnetic resonance imaging for the detection of meniscus posterior root pathology. Knee Surg Sports Traumatol Arthrosc. 2015;23:152–57.PubMedCrossRefGoogle Scholar
  45. 45.
    Matheny LM, Ockuly AC, Steadman JR, LaPrade RF. Posterior meniscus root tears: associated pathologies to assist as diagnostic tools. Knee Surg Sports Traumatol Arthrosc. 2015;23:3127–31.PubMedCrossRefGoogle Scholar
  46. 46.
    Kim YJ, Kim JG, Chang SH, Shim JC, Kim SB, Lee MY. Posterior root tear of the medial meniscus in multiple knee ligament injuries. Knee. 2010;17:324–8.PubMedCrossRefGoogle Scholar
  47. 47.
    Ra HJ, Ha JK, Jang HS, Kim JG. Traumatic posterior root tear of the medial meniscus in patients with severe medial instability of the knee. Knee Surg Sports Traumatol Arthrosc. 2015;23:3121–6.PubMedCrossRefPubMedCentralGoogle Scholar
  48. 48.
    McCulloch PC, Shybut TB, Isamaily SK, et al. The effect of progressive degrees of medial meniscal loss on stability after anterior cruciate ligament reconstruction. J Knee Surg. 2013;26:363–9.PubMedCrossRefPubMedCentralGoogle Scholar
  49. 49.
    LaPrade CM, Jansson KS, Dornan G, Smith SD, Wijdicks CA, LaPrade RF. Altered tibiofemoral contact mechanics due to lateral meniscus posterior horn root avulsions and radial tears can be restored with in situ pull-out suture repairs. J Bone Joint Surg Am. 2014;96:471–9.PubMedCrossRefPubMedCentralGoogle Scholar
  50. 50.
    Marzo JM, Gurske-DePerio J. Effects of medial meniscus posterior horn avulsion and repair on tibiofemoral contact area and peak contact pressure with clinical implications. Am J Sports Med. 2009;37:124–9.PubMedCrossRefGoogle Scholar
  51. 51.
    Schillhammer CK, Werner FW, Scuderi MG, Cannizzaro JP. Repair of lateral meniscus posterior horn detachment lesions: a biomechanical evaluation. Am J Sports Med. 2012;40:2604–9.PubMedCrossRefGoogle Scholar
  52. 52.
    Shybut TB, Vega CE, Haddad J, et al. Effect of lateral meniscal root tear on the stability of the anterior cruciate ligament-deficient knee. Am J Sports Med. 2015;43:905–11.PubMedPubMedCentralCrossRefGoogle Scholar
  53. 53.
    Frank JM, Moatshe G, Brady AW, et al. Lateral meniscus posterior root and meniscofemoral ligaments as stabilizing structures in the ACL-deficient knee: a biomechanical study. Orthop J Sports Med. 2017;5:2325967117695756.PubMedPubMedCentralCrossRefGoogle Scholar
  54. 54.
    Englund M, Roos EM, Roos HP, Lohmander LS. Patient-relevant outcomes fourteen years after meniscectomy: influence of type of meniscal tear and size of resection. Rheumatology (Oxford). 2001;40:631–9.CrossRefGoogle Scholar
  55. 55.
    Kim SJ, Chun YM, Jeong JH, Ryu SW, Oh KS, Lubis AM. Effects of arthroscopic meniscectomy on the long-term prognosis for the discoid lateral meniscus. Knee Surg Sports Traumatol Arthrosc. 2007;15:1315–20.PubMedCrossRefGoogle Scholar
  56. 56.
    Papalia R, Del Buono A, Osti L, Denaro V, Maffulli N. Meniscectomy as a risk factor for knee osteoarthritis: a systematic review. Br Med Bull. 2011;99:89–106.PubMedCrossRefGoogle Scholar
  57. 57.
    Rodeo SA. Meniscal allografts–where do we stand? Am J Sports Med. 2001;29:246–61.PubMedCrossRefGoogle Scholar
  58. 58.
    Salata MJ, Gibbs AE, Sekiya JK. A systematic review of clinical outcomes in patients undergoing meniscectomy. Am J Sports Med. 2010;38:1907–16.PubMedCrossRefGoogle Scholar
  59. 59.
    King AG. Meniscal lesions in children and adolescents: a review of the pathology and clinical presentation. Injury. 1983;15:105–8.PubMedCrossRefGoogle Scholar
  60. 60.
    Moon HK, Koh YG, Kim YC, Park YS, Jo SB, Kwon SK. Prognostic factors of arthroscopic pull-out repair for a posterior root tear of the medial meniscus. Am J Sports Med. 2012;40:1138–43.PubMedCrossRefPubMedCentralGoogle Scholar
  61. 61.
    Noyes FR, Barber-Westin SD, Butler DL, Wilkins RM. The role of allografts in repair and reconstruction of knee joint ligaments and menisci. Instr Course Lect. 1998;47:379–96.PubMedPubMedCentralGoogle Scholar
  62. 62.
    Garrett JC. Meniscal transplantation. Am J Knee Surg. 1996;9:32–4.PubMedPubMedCentralGoogle Scholar
  63. 63.
    Shelbourne KD, Gray T. Results of anterior cruciate ligament reconstruction based on meniscus and articular cartilage status at the time of surgery. Five- to fifteen-year evaluations. Am J Sports Med. 2000;28:446–52.PubMedCrossRefPubMedCentralGoogle Scholar
  64. 64.
    Garrett JC, Steensen RN. Meniscal transplantation in the human knee: a preliminary report. Arthroscopy. 1991;7:57–62.PubMedCrossRefGoogle Scholar
  65. 65.
    Cameron JC, Saha S. Meniscal allograft transplantation for unicompartmental arthritis of the knee. Clin Orthop Relat Res. 1997:164–171.CrossRefGoogle Scholar
  66. 66.
    Siegel MG, Roberts CS. Meniscal allografts. Clin Sports Med. 1993;12:59–80.PubMedGoogle Scholar
  67. 67.
    Debeer P, Decorte R, Delvaux S, Bellemans J. DNA analysis of a transplanted cryopreserved meniscal allograft. Arthroscopy. 2000;16:71–5.PubMedCrossRefGoogle Scholar
  68. 68.
    Fabbriciani C, Lucania L, Milano G, Schiavone Panni A, Evangelisti M. Meniscal allografts: cryopreservation vs deep-frozen technique. An experimental study in goats. Knee Surg Sports Traumatol Arthrosc. 1997;5:124–34.PubMedCrossRefGoogle Scholar
  69. 69.
    Gibbons MJ, Butler DL, Grood ES, Bylski-Austrow DI, Levy MS, Noyes FR. Effects of gamma irradiation on the initial mechanical and material properties of goat bone-patellar tendon-bone allografts. J Orthop Res. 1991;9:209–18.CrossRefGoogle Scholar
  70. 70.
    Schwartz HE, Matava MJ, Proch FS, et al. The effect of gamma irradiation on anterior cruciate ligament allograft biomechanical and biochemical properties in the caprine model at time zero and at 6 months after surgery. Am J Sports Med. 2006;34:1747–55.PubMedCrossRefPubMedCentralGoogle Scholar
  71. 71.
    Shaffer B, Kennedy S, Klimkiewicz J, Yao L. Preoperative sizing of meniscal allografts in meniscus transplantation. Am J Sports Med. 2000;28:524–33.PubMedCrossRefPubMedCentralGoogle Scholar
  72. 72.
    Veltri DM, Warren RF, Wickiewicz TL, O’Brien SJ. Current status of allograft meniscal transplantation. Clin Orthop Relat Res. 1994:44–55.Google Scholar
  73. 73.
    Dienst M, Greis PE, Ellis BJ, Bachus KN, Burks RT. Effect of lateral meniscal allograft sizing on contact mechanics of the lateral tibial plateau: an experimental study in human cadaveric knee joints. Am J Sports Med. 2007;35:34–42.PubMedCrossRefPubMedCentralGoogle Scholar
  74. 74.
    Pollard ME, Kang Q, Berg EE. Radiographic sizing for meniscal transplantation. Arthroscopy. 1995;11:684–7.PubMedCrossRefPubMedCentralGoogle Scholar
  75. 75.
    Kohn D, Wirth CJ, Reiss G et al. Medial meniscus replacement by a tendon autograft. Experiments in sheep. J Bone Joint Surg Br. 1992;74:910–7.CrossRefGoogle Scholar
  76. 76.
    Alhalki MM, Howell SM, Hull ML. How three methods for fixing a medial meniscal autograft affect tibial contact mechanics. Am J Sports Med. 1999;27:320–8.PubMedCrossRefPubMedCentralGoogle Scholar
  77. 77.
    Alhalki MM, Hull ML, Howell SM. Contact mechanics of the medial tibial plateau after implantation of a medial meniscal allograft. A human cadaveric study. Am J Sports Med. 2000;28:370–6.PubMedCrossRefPubMedCentralGoogle Scholar
  78. 78.
    Chen MI, Branch TP, Hutton WC. Is it important to secure the horns during lateral meniscal transplantation? A cadaveric study. Arthroscopy. 1996;12:174–81.PubMedCrossRefPubMedCentralGoogle Scholar
  79. 79.
    Gao J, Wei X, Messner K. Healing of the anterior attachment of the rabbit meniscus to bone. Clin Orthop Relat Res. 1998:246–58.CrossRefGoogle Scholar
  80. 80.
    Shibuya S. Meniscus transplantation using a cryopreserved allograft. Histological and ultrastructural study of the transplanted meniscus. J Orthop Sci. 1999;4:135–41.PubMedCrossRefGoogle Scholar
  81. 81.
    Owens BD, Neault M, Benson E, Busconi BD. Primary repair of knee dislocations: results in 25 patients (28 knees) at a mean follow-up of four years. J Orthop Trauma. 2007;21:92–6.CrossRefGoogle Scholar
  82. 82.
    Lill H, Hepp P, Rose T, Engel T, Kunzel E, Josten C. Fresh meniscal allograft transplantation and autologous ACL/PCL reconstruction in a patient with complex knee trauma following knee dislocation—a case report. Scand J Med Sci Sports. 2004;14:112–5.PubMedCrossRefGoogle Scholar
  83. 83.
    Mitchell R, Pitts R, Kim YM, Matava MJ. Medial meniscal root avulsion: a biomechanical comparison of 4 different repair constructs. Arthroscopy. 2016;32:111–9.PubMedCrossRefGoogle Scholar
  84. 84.
    Robinson JR, Frank EG, Hunter AJ, Jermin PJ, Gill HS. The strength of transosseous medial meniscal root repair using a simple suture technique is dependent on suture material and position. Am J Sports Med. 2018;46:924–32.PubMedCrossRefPubMedCentralGoogle Scholar
  85. 85.
    Feucht MJ, Grande E, Brunhuber J, et al. Biomechanical comparison between suture anchor and transtibial pull-out repair for posterior medial meniscus root tears. Am J Sports Med. 2014;42:187–93.PubMedCrossRefPubMedCentralGoogle Scholar
  86. 86.
    DeBerardino TM. Arthroscopically assisted meniscal allograft transplantation. Oper Tech Sports Med. 2005;13:5.Google Scholar
  87. 87.
    Thompson WO, Thaete FL, Fu FH, Dye SF. Tibial meniscal dynamics using three-dimensional reconstruction of magnetic resonance images. Am J Sports Med. 1991;19:210–5; discussion 215–6.PubMedCrossRefPubMedCentralGoogle Scholar
  88. 88.
    Morgan CD, Wojtys EM, Casscells CD, Casscells SW. Arthroscopic meniscal repair evaluated by second-look arthroscopy. Am J Sports Med. 1991;19:632–7; discussion 637-638.PubMedCrossRefPubMedCentralGoogle Scholar
  89. 89.
    Rijk PC. Meniscal allograft transplantation–part I: background, results, graft selection and preservation, and surgical considerations. Arthroscopy. 2004;20:728–43.PubMedCrossRefPubMedCentralGoogle Scholar
  90. 90.
    Stollsteimer GT, Shelton WR, Dukes A, Bomboy AL. Meniscal allograft transplantation: a 1- to 5-year follow-up of 22 patients. Arthroscopy. 2000;16:343–7.PubMedCrossRefGoogle Scholar
  91. 91.
    Kidron A, Thein R. Radial tears associated with cleavage tears of the medial meniscus in athletes. Arthroscopy. 2002;18:254–6.PubMedCrossRefGoogle Scholar
  92. 92.
    van der Wal RJ, Thomassen BJ, van Arkel ER. Long-term clinical outcome of open meniscal allograft transplantation. Am J Sports Med. 2009;37:2134–9.PubMedCrossRefGoogle Scholar
  93. 93.
    Wirth CJ, von Lewinski G. Long-term results after combined medial meniscal allograft transplantation and anterior cruciate ligament reconstruction: minimum 8.5-year follow-up study. Arthroscopy. 2004;20:782–3; author reply 784–5.Google Scholar
  94. 94.
    Noyes FR, Barber-Westin SD, Rankin M. Meniscal transplantation in symptomatic patients less than fifty years old. J Bone Joint Surg Am. 2004;86-A:1392–404.PubMedCrossRefGoogle Scholar
  95. 95.
    Paletta GA, Jr., Manning T, Snell E, Parker R, Bergfeld J. The effect of allograft meniscal replacement on intraarticular contact area and pressures in the human knee. A biomechanical study. Am J Sports Med. 1997;25:692–8.PubMedCrossRefGoogle Scholar
  96. 96.
    Kaeding CC, Pedroza AD, Parker RD, Spindler KP, McCarty EC, Andrish JT. Intra-articular findings in the reconstructed multiligament-injured knee. Arthroscopy. 2005;21:424–30.PubMedPubMedCentralCrossRefGoogle Scholar
  97. 97.
    Harner CD, Mauro CS, Lesniak BP, Romanowski JR. Biomechanical consequences of a tear of the posterior root of the medial meniscus. Surgical technique. J Bone Joint Surg Am. 2009;91 Suppl 2:257–70.PubMedCrossRefGoogle Scholar
  98. 98.
    McDermott ID, Lie DT, Edwards A, Bull AM, Amis AA. The effects of lateral meniscal allograft transplantation techniques on tibio-femoral contact pressures. Knee Surg Sports Traumatol Arthrosc. 2008;16:553–60.PubMedCrossRefGoogle Scholar
  99. 99.
    Szomor ZL, Martin TE, Bonar F, Murrell GA. The protective effects of meniscal transplantation on cartilage. An experimental study in sheep. J Bone Joint Surg Am. 2000;82:80–8.PubMedCrossRefGoogle Scholar
  100. 100.
    Kelly BT, Potter HG, Deng XH, et al. Meniscal allograft transplantation in the sheep knee: evaluation of chondroprotective effects. Am J Sports Med. 2006;34:1464–77.PubMedCrossRefGoogle Scholar
  101. 101.
    Rijk PC, de Rooy TP, Coerkamp EG, Bernoski FP, van Noorden CJ. Radiographic evaluation of the knee joint after meniscal allograft transplantation. An experimental study in rabbits. Knee Surg Sports Traumatol Arthrosc. 2002;10:241–6.PubMedCrossRefGoogle Scholar
  102. 102.
    Rijk PC, Tigchelaar-Gutter W, Bernoski FP, Van Noorden CJ. Functional changes in articular cartilage after meniscal allograft transplantation: a quantitative histochemical evaluation in rabbits. Arthroscopy. 2006;22:152–8.PubMedCrossRefGoogle Scholar
  103. 103.
    Ha JK, Shim JC, Kim DW, Lee YS, Ra HJ, Kim JG. Relationship between meniscal extrusion and various clinical findings after meniscus allograft transplantation. Am J Sports Med. 2010;38:2448–55.PubMedCrossRefGoogle Scholar
  104. 104.
    Verdonk PC, Verstraete KL, Almqvist KF, et al. Meniscal allograft transplantation: long-term clinical results with radiological and magnetic resonance imaging correlations. Knee Surg Sports Traumatol Arthrosc. 2006;14:694–706.PubMedCrossRefGoogle Scholar
  105. 105.
    Jung YH, Choi NH, Oh JS, Victoroff BN. All-inside repair for a root tear of the medial meniscus using a suture anchor. Am J Sports Med. 2012;40:1406–11.PubMedCrossRefGoogle Scholar
  106. 106.
    Arnoczky SP, Warren RF, McDevitt CA. Meniscal replacement using a cryopreserved allograft. An experimental study in the dog. Clin Orthop Relat Res. 1990:121–8.Google Scholar
  107. 107.
    Jackson DW, McDevitt CA, Simon TM, Arnoczky SP, Atwell EA, Silvino NJ. Meniscal transplantation using fresh and cryopreserved allografts. An experimental study in goats. Am J Sports Med. 1992;20:644–56.PubMedCrossRefGoogle Scholar
  108. 108.
    Jackson DW, Whelan J, Simon TM. Cell survival after transplantation of fresh meniscal allografts. DNA probe analysis in a goat model. Am J Sports Med. 1993;21:540–50.PubMedCrossRefGoogle Scholar
  109. 109.
    Rodeo SA, Seneviratne A, Suzuki K, Felker K, Wickiewicz TL, Warren RF. Histological analysis of human meniscal allografts. A preliminary report. J Bone Joint Surg Am. 2000;82-A:1071–82.PubMedCrossRefGoogle Scholar
  110. 110.
    Bhosale AM, Myint P, Roberts S, et al. Combined autologous chondrocyte implantation and allogenic meniscus transplantation: a biological knee replacement. Knee. 2007;14:361–8.PubMedCrossRefPubMedCentralGoogle Scholar
  111. 111.
    Cole BJ, Dennis MG, Lee SJ, et al. Prospective evaluation of allograft meniscus transplantation: a minimum 2-year follow-up. Am J Sports Med. 2006;34:919–27.PubMedCrossRefPubMedCentralGoogle Scholar
  112. 112.
    Graf KW, Jr., Sekiya JK, Wojtys EM, Department of Orthopaedic Surgery UoMMCAAMUSA. Long-term results after combined medial meniscal allograft transplantation and anterior cruciate ligament reconstruction: minimum 8.5-year follow-up study. Arthroscopy. 2004;20:129–40.Google Scholar
  113. 113.
    LaPrade RF, Wills NJ, Spiridonov SI, Perkinson S. A prospective outcomes study of meniscal allograft transplantation. Am J Sports Med. 2010;38:1804–12.PubMedCrossRefPubMedCentralGoogle Scholar
  114. 114.
    Hommen JP, Applegate GR, Del Pizzo W. Meniscus allograft transplantation: ten-year results of cryopreserved allografts. Arthroscopy. 2007;23:388–93.PubMedCrossRefPubMedCentralGoogle Scholar
  115. 115.
    Vundelinckx B, Bellemans J, Vanlauwe J. Arthroscopically assisted meniscal allograft transplantation in the knee: a medium-term subjective, clinical, and radiographical outcome evaluation. Am J Sports Med. 2010;38:2240–7.PubMedCrossRefPubMedCentralGoogle Scholar
  116. 116.
    Farr J, Rawal A, Marberry KM. Concomitant meniscal allograft transplantation and autologous chondrocyte implantation: minimum 2-year follow-up. Am J Sports Med. 2007;35:1459–66.PubMedCrossRefPubMedCentralGoogle Scholar
  117. 117.
    van Arkel ER, de Boer HH. Human meniscal transplantation. Preliminary results at 2 to 5-year follow-up. J Bone Joint Surg Br. 1995;77:589–95.Google Scholar
  118. 118.
    Ryu RK, Dunbar VW, Morse GG. Meniscal allograft replacement: a 1-year to 6-year experience. Arthroscopy. 2002;18:989–94.PubMedCrossRefPubMedCentralGoogle Scholar
  119. 119.
    Yoldas EA, Sekiya JK, Irrgang JJ, Fu FH, Harner CD. Arthroscopically assisted meniscal allograft transplantation with and without combined anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 2003;11:173–82.PubMedCrossRefPubMedCentralGoogle Scholar
  120. 120.
    Noyes FR B-WS. Irradiated meniscus allografts in the human knee. A two to five year follow-up study. Orthop Trans. 1995;19:1.Google Scholar
  121. 121.
    Potter HG, Rodeo SA, Wickiewicz TL, Warren RF. MR imaging of meniscal allografts: correlation with clinical and arthroscopic outcomes. Radiology. 1996;198:509–14.PubMedCrossRefGoogle Scholar
  122. 122.
    Johnson DL, Bealle D. Meniscal allograft transplantation. Clin Sports Med. 1999;18:93–108.PubMedCrossRefPubMedCentralGoogle Scholar
  123. 123.
    Gonzalez-Lucena G, Gelber PE, Pelfort X, Tey M, Monllau JC. Meniscal allograft transplantation without bone blocks: a 5- to 8-year follow-up of 33 patients. Arthroscopy. 2010;26:1633–40.PubMedCrossRefGoogle Scholar
  124. 124.
    Rath E, Richmond JC, Yassir W, Albright JD, Gundogan F. Meniscal allograft transplantation. Two- to eight-year results. Am J Sports Med. 2001;29:410–4.PubMedCrossRefPubMedCentralGoogle Scholar
  125. 125.
    Van Thiel GS, Verma N, Yanke A, Basu S, Farr J, Cole B. Meniscal allograft size can be predicted by height, weight, and gender. Arthroscopy. 2009;25:722–7.PubMedCrossRefPubMedCentralGoogle Scholar
  126. 126.
    Verdonk PC, Demurie A, Almqvist KF, Veys EM, Verbruggen G, Verdonk R. Transplantation of viable meniscal allograft. Survivorship analysis and clinical outcome of one hundred cases. J Bone Joint Surg Am. 2005;87:715–24.CrossRefGoogle Scholar
  127. 127.
    Sekiya JK, Giffin JR, Irrgang JJ, Fu FH, Harner CD. Clinical outcomes after combined meniscal allograft transplantation and anterior cruciate ligament reconstruction. Am J Sports Med. 2003;31:896–906.PubMedCrossRefPubMedCentralGoogle Scholar
  128. 128.
    von Lewinski G, Milachowski KA, Weismeier K, Kohn D, Wirth CJ. Twenty-year results of combined meniscal allograft transplantation, anterior cruciate ligament reconstruction and advancement of the medial collateral ligament. Knee Surg Sports Traumatol Arthrosc. 2007;15:1072–82.CrossRefGoogle Scholar
  129. 129.
    Rueff D, Nyland J, Kocabey Y, Chang HC, Caborn DN. Self-reported patient outcomes at a minimum of 5 years after allograft anterior cruciate ligament reconstruction with or without medial meniscus transplantation: an age-, sex-, and activity level-matched comparison in patients aged approximately 50 years. Arthroscopy. 2006;22:1053–62.PubMedCrossRefGoogle Scholar
  130. 130.
    Amendola A. Knee osteotomy and meniscal transplantation: indications, technical considerations, and results. Sports Med Arthrosc Rev. 2007;15:32–8.PubMedCrossRefPubMedCentralGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Michael A. Donohue
    • 1
    Email author
  • Matthew A. Posner
    • 2
  • Adam M. Pickett
    • 3
  • Chad A. Haley
    • 2
  1. 1.Department of Orthopaedic SurgeryKeller Army Community HospitalWest PointUSA
  2. 2.John a Feagin Jr Sports Medicine FellowshipKeller Army Community HospitalWest PointUSA
  3. 3.OrthopedicsKeller Army Community HospitalWest PointUSA

Personalised recommendations