Name: Segmental Meniscal Allograft Transplantation Using the Segmental Meniscus Procedure Pack
Uploaded: 2026-07-01T00:00:00Z
Channel: Arthrex
Description: Jonathan A. Godin, MD (Vail, CO), performs a segmental meniscal allograft transplantation (MAT) using the segmental meniscus procedure pack to treat a midbody meniscal defect. Dr. Godin also shares key tips and technical pearls for using the meniscus template included in the procedure pack to ensure optimal graft matching.

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Jonathan A. Godin, MD (Vail, CO), performs a segmental meniscal allograft transplantation (MAT) using the segmental meniscus procedure pack to treat a midbody meniscal defect. Dr. Godin also shares key tips and technical pearls for using the meniscus template included in the procedure pack to ensure optimal graft matching.

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VID1-009964-en-US | A | Segmental Meniscal Allograft Transplantation Using the Segmental Meniscus Procedure Pack

Jonathan A. Godin, MD (Vail, CO)

A video recording of a surgical technique on a live patient in an operating room setting or a cadaveric demonstration.

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Segmental Meniscal Allograft Transplantation Using the Segmental Meniscus Procedure Pack

Speaker  This is John Golden from the Stomach Clinic in Vail, Colorado. We're going to go over the components that comprise the segmental M.a.t. procedure pack. There are many suture tape links with or without needles, with four distinct colors for the corresponding four quadrants of the graft. And then there are also associated mini suture tape links without needles that will go into the graft. In addition, there is a free needle with a nitinol loop, and one of the most unique aspects of this is the meniscus template for the meniscus template. This is made of the same material as that used for the passport, and you can see distinct radii of curvature throughout the graft template. Four different quadrants showing different radii of curvature that would fit most appropriately in the segmental meniscus defect. Another key feature is that you can trim this to size for the height of the meniscus. Lastly, you can pass a suture through this so that you have complete control of the template within the knee joint for easy placement and extraction. We're starting the prep on a segmental M80. This is a right knee, and we're working on a mid body segmental defect here. We've begun some of the prep with biters and the torpedo shaver. And just doing the finishing touches on that right now with the shaver first. And you can use a combination of different biters to finish your prep work. Speaker  Key here is going to be coming from your control departmental portal to finish to have the best angle to work around the tibial spines. So you can kind of see we're finishing getting an appropriate. You want to leave at least a millimeter of rim if you can. And then another key here is keeping the edges, the anterior and posterior edges as sharp as you can to maximize some of the surface area. And then you'll want to mimic the pattern on your allograft on the back table. As is commonplace, we have fenestrated the proximal MCL to help with our exposure for this procedure helps with a valgus force applied for your visualization. So I'm going to do is switch portals view from our lateral portal to see and measure our defect. Now with the SCR ruler. So we're getting our anterior to posterior dimension here which on this is about a 19 or so nice clean edges nice rim there to repair and have healing to that. You notice the cartilage in the specimen is quite good. The other thing that I'll point out is that we've got our approach for our inside out, a typical inside out. I tend to use a probe to mark the joint line, and I make a third of the incision above that, two thirds below. Speaker  Once we get through the subcutaneous tissue, we're identifying the Sartorius fascia here. And I've kind of come in line with that to retract the hamstrings. And then below that, we're going to have our layer of the capsule and the postero medial gastrocnemius. So there are obviously different dimensions here. The most important is going to be your anterior to posterior. In my opinion, you don't want to short that and have too much strain across the radial repair sites anteriorly and posteriorly. And so getting that is the most vital. You're going to have a size matched graft. And so but sometimes the width is going to be variable. And it doesn't matter as much if there's nothing you can do. If this is a little bit inset after you place the graft in. If it's a little if there's a little excess, if you want just for appearance, it can be trimmed. And then the last is going to be the height. And so that's where we'll use the template. And we can size that more appropriately, which then allows us to size the allograft on the back table before we put it in. Once you have your segmental defect prepped arthroscopically, you can go to the back table. What we've done here is removed a right medial meniscus allograft from the corresponding bone. And then we have the template. Speaker  And so you'll want to use the template to identify the corresponding radius of curvature that best fits the area that you'll be transplanting. And so you can see the shorter radius of curvature here all the way to the longest. And if we put this on the corresponding area that we would be transplanting for this patient. Zone two has the best fit whereas three. And certainly this fourth zone here don't match the radius of curvature as well. And then we have the sizing. And so we can again use that ruler that we used arthroscopically. And within that zone we'll be able to measure to the same length. In this case it measured a 19. So I'll go about a 20 to size the template. And then we can mark the template with a stay stitch and put it into the joint to make sure that the fit is perfect. One thing I would note here, I tried to get pretty right angles on my defect. If you have more of a lower angle than. I would cut that appropriately to try to match when it fits in the joint. And so now we have a 20 millimeter portion on the outer rim for our template here. And I'm going to put a tag stitch in this. Personally, I think the anterosuperior quadrant is the easiest to place. So what we've done is made a small about a millimeter trim in the anterior to posterior position. Speaker  And then we've cut the template at the top of our fourth marking. And the nice thing with this material is the durability and the ease with which you can go in and out. And then I pass this, this link again in it. And you can see that the, the material stands up to that quite easily. So here I'm going to check the anterior posterior position, which looks quite good front to back. And then this view here I'll be checking the height. If this were placed in like that. So in standard fashion, we've placed our mini tape links into the four quadrants Anterosuperior, Anteroinferior, Posterosuperior, and Posteroinferior. And you can see those there. In this case, we used a divider in the passport to help organize those. And then we will refer to those corresponding colors when we pass these links to help shuttle the graph to keep everything sorted out later in the case. Now we'll go to the back table to prep our allograft. So now we're on the back table. We have our template. And if you think of the three dimensions looking at it, the height was appropriate to this template. So that's what we're going to aim for on the allograft as was. Now that we've fine tuned it our A to p length, the width is something I'm keeping in mind. Speaker  And so anatomically This zone is where the segmental defect is. I'm going to come just a little bit anterior because it's a little thinner there, and I think more appropriately matches the size of our template in that zone. Now that we've got the appropriate size in all three dimensions, we'll pass all four of our links in corresponding fashion to the colors that we place them in our defect. So here's the final prepared allograft on the back table with our blue Anterosuperior black Anteroinferior white and blue Posterosuperior and white and black Posteroinferior links passed in luggage tag fashion. We'll now pass these of the corresponding colors in the knee. So now we're going to pass first our two posterior shuttle stitches to feed the posterior mini tape links that are in the graph that have been passed. And this will help pull the graft in. And I'm also going to push with a king fisher. So now what I'm going to do after we have it provisionally placed is Thai order in my opinion doesn't matter. I'm going to for this case do posterior first. So as you can see I'm tying the blue and black striped links together first. And then next we'll tie the anterior solid blue to solid black. So now we have our stability of the graft to the rim. Speaker  And then you can augment with all inside fiber stitch or inside out sutures and side to side fashion to stabilize the graft to the anterior native meniscus and the posterior. So now we're placing a 24 degree fiber stitch in the posterior aspect at the junction of the graft to native meniscus. So here is kind of the final product. You can see that we've added side to side anteriorly in this case with an all inside fiber stitch. This can also be done with an inside out, and this will nicely reduce the allograft to the anterior aspect of the native meniscus. We've done the same posteriorly to reduce the posterior aspect of the native meniscus to the allograft, and then we can cycle the knee gently there to check it. Post-operatively. What I'm currently doing is six weeks non-weight bearing on these. Similar to a meniscal allograft transplantation with a brace start PT immediately post op day one swelling minimization range of motion. Usually do 0 to 90 for two weeks, then advance as tolerated. Usually it's about a 1 to 2 week progression from non-weight bearing at week six. Goal would be about checking strength at three months, six months, then nine months if need be, with a 10% or less differential between the sides before return to sport.

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Segmental Meniscal Allograft Transplantation Using the Segmental Meniscus Procedure Pack

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