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Cadaveric meniscal transplant

Case contributed by Chris O'Donnell
Diagnosis certain

Presentation

Meniscectomy at a young age. Recent arthroscopic meniscal transplant for assessment

Patient Data

Age: 25 years
Gender: Female

Post meniscal transplant

mri

Typical mensical appearance with bony tunnels anteriorly and posteriorly (arrows) containing sutures attached to the medial tibia by a metallic screw. Note articular cartilage is intact.

MRI pre meniscal transplant

mri

Post meniscectomy.

Case Discussion

Meniscal transplantation is technically difficult, as it must be correctly sized, placed accurately on the tibia and tightly secured to the tibial plateau.  A major issue is this attachment varying from tunneled sutures (as in this case) to metallic fixation of bone plugs attached to the graft mensicus.  In this case the mensicus has also been sewn peripherally onto the medial capsule.

In general meniscus transplantation is only performed in meniscus deficient patients if they are young and articular cartilage is preserved.  The residual native meniscus is trimmed away prior to placement of the transplant.

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