Arthroscopic Meniscal Allograft Transplantation With Soft-Tissue Fixation Through Bone Tunnels  Tim Spalding, F.R.C.S.(Orth), Ben Parkinson, F.R.A.C.S.Orth, Nick A. Smith, M.Sc., M.R.C.S., Peter Verdonk, Ph.D.  Arthroscopy Techniques  Volume 4, Issue 5, Pages e559-e563 (October 2015) DOI: 10.1016/j.eats.2015.06.001 Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

Fig 1 The meniscal allograft has been dissected from the tibia and trimmed. It has then been labeled to aid orientation when inserting the graft into the knee. Whipstitches have been placed on the anterior and posterior horns to aid insertion and securing of the graft roots to the knee. Arthroscopy Techniques 2015 4, e559-e563DOI: (10.1016/j.eats.2015.06.001) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

Fig 2 (A) The lead sutures have been passed through the bone tunnels and out through the working portal. The middle traction suture has also been passed just anterior to the popliteus tendon and out through the working portal. The Arthrex PassPort silicone cannula is inserted through the working portal. (B) A lead suture is passed through the previously drilled posterior horn tunnel. This is then pulled through the working portal with a suture manipulator and clipped to the side. The same technique is used for the anterior horn tunnel. Arthroscopy Techniques 2015 4, e559-e563DOI: (10.1016/j.eats.2015.06.001) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

Fig 3 The meniscal horn whipstitches have been passed through the working portal and out through the bone tunnels. The allograft is then pulled into the knee using the whipstitches and middle traction suture. The posterior horn is the lead suture for pulling the allograft into the knee. Arthroscopy Techniques 2015 4, e559-e563DOI: (10.1016/j.eats.2015.06.001) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

Fig 4 (A) The lateral meniscal allograft is in place (left knee), and vertical mattress sutures are placed at its superior surface. (B) The lateral meniscal allograft is in place (left knee), and vertical mattress sutures are placed at its inferior surface. (C) Final position of the lateral meniscal allograft transplant in the left knee. The meniscal horn sutures have been tied over the bone bridge, and sutures to the body have also been tied. Arthroscopy Techniques 2015 4, e559-e563DOI: (10.1016/j.eats.2015.06.001) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions