Suture‐Only Fixation of Meniscal Allograft Is Associated With a Higher Reoperation Rate Than Bone Plug or Bone Bridge‐in‐Slot Fixation Techniques

This retrospective single-institution cohort study looked at 139 patients who underwent meniscal allograft transplantation (MAT) between 2011 and 2023, comparing three graft fixation methods: suture-only, bone plug, and bone bridge-in-slot. Over a mean follow-up of about 6.6 years, patients fixed with suture-only technique had a meniscus-specific reoperation rate of 31.3% (15/48), compared with 10.9% for bone plug and 8.9% for bone bridge-in-slot fixation (P = .006), and multivariable analysis showed suture-only fixation carried roughly 10-fold higher odds of reoperation versus bone bridge-in-slot fixation (OR 10.04, 95% CI 2.46-40.98).

AI summary · from the full text · reviewed by Pukhraj Gaheer, Medical Student, Queen's University before publishing

Why it mattersFor sports medicine surgeons performing MAT, this suggests that fixation technique choice may meaningfully affect graft durability and reoperation risk, information relevant to surgical planning and patient counseling.

Presenting this at rounds? Start here

• ?This is a retrospective, non-randomized cohort with fixation technique chosen by surgeon preference and correlated with compartment (bone plug mostly medial, bone bridge mostly lateral); how much of the reoperation difference could reflect compartment-specific biology rather than fixation method itself?
• ?If you were counseling a patient who needs lateral MAT, would this study change your fixation choice given that bone bridge-in-slot was used almost exclusively laterally and had the lowest reoperation rate, or would you want randomized data controlling for compartment first?