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 of 139 patients who underwent meniscal allograft transplantation (MAT) compared reoperation rates among three graft fixation techniques: suture-only, bone plug, and bone bridge-in-slot. Over a mean follow-up of 6.6 years, patients with suture-only fixation had a much higher meniscus-specific reoperation rate (15/48, 31.3%) than those with bone bridge-in-slot (4/45, 8.9%) or bone plug (5/46, 10.9%) fixation (P = .006), and on multivariable analysis suture-only fixation carried roughly 10-fold higher odds of reoperation versus bone bridge-in-slot fixation (OR 10.05, 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 surgeons performing meniscal allograft transplantation, this study suggests that fixation technique choice may meaningfully affect long-term graft durability and reoperation risk, a key consideration in patient counseling and surgical planning.

Presenting this at rounds? Start here

• ?Given that fixation technique was chosen by surgeon preference rather than randomized, how might confounding by indication (e.g., compartment, graft morphology, surgeon skill) explain part of the observed difference in reoperation rates?
• ?If you were counseling a young patient with lateral meniscal deficiency, would this single-institution retrospective study be enough to steer you away from suture-only fixation, or would you want prospective confirmation first?