Suture‐Only Fixation of Meniscal Allograft Is Associated With a Higher Reoperation Rate Than Bone Plug or Bone Bridge‐in‐Slot Fixation Techniques
Arthroscopy The Journal of Arthroscopic and Related Surgery · 22 Jul 2026
† Impact is the editorial-priority score. All scores are out of 100. Clinical is a stored clinical-importance score from the earlier method; it has not been recalculated.
Why it matters
For 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 counselling and surgical planning.
The evidence
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).
meniscus-specific reoperation: Odds ratio 10.04 (95% CI 2.46 to 40.98; units not reported). The interval favours the comparator; the size of the disadvantage needs clinical interpretation.
Why this rigour score?
Retrospective cohort
Methods at a glance
Recorded assessment- Confounding adjustmentMultivariable regression
- Covariate balance confirmedNot reported
- Outcome assessors blindedNot reported
- Comparable start of follow-upMet
- Adequate statistical powerNot reported
- Prospective registrationNot met
Not reported does not mean not done. Checks have different weights; this is not a count of boxes ticked.
How to read this assessment
The recorded methods are shown alongside the published score. A verified point-by-point calculation is not available for this version of the appraisal.
Checklist from the stored appraisal. “Not met” describes the recorded criterion; it does not always produce a deduction. This overview supports reading the full study.
For journal club
1.Given that fixation technique was chosen by surgeon preference rather than randomised, how might confounding by indication (e.g., compartment, graft morphology, surgeon skill) explain part of the observed difference in reoperation rates?
2.If you were counselling 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?
Original publication title
Suture‐Only Fixation of Meniscal Allograft Is Associated With a Higher Reoperation Rate Than Bone Plug or Bone Bridge‐in‐Slot Fixation Techniques