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Dr. Garcia demonstrates his cutting edge technique for medial meniscus transplantation.
Dr. Garcia specializes in complex knee, shoulder and elbow sports surgeries. He has prepared a number of surgical videos below to help patients better understand their procedures. He is frequently updating his surgical video database so check back soon for further updates.
In this video, Dr. Grant H. Garcia demonstrates a medial meniscus transplantation using a dual bone plug technique (an 8mm posterior bone plug and a 9mm anterior bone plug).
The detailed stages of the surgical procedure are outlined below:
- Joint Inspection & Debridement: The surgeon confirms that the knee's cartilage is completely intact. He prepares the joint by trephinating the medial collateral ligament (MCL) for spacing, removing the damaged native meniscus remnants, and cleaning off a small portion of the tibial spine and posterior cruciate ligament (PCL) to optimize visualization.
- Portal & Tunnel Preparation: A 12mm Passport cannula is placed to preserve fluid management. Dr. Garcia performs a reverse notchplasty and uses an Arthrex FlipCutter to drill a precise 15mm-deep socket into the native posterior meniscus root attachment footprint.
- Donor Allograft Preparation: On the back table, the donor medial meniscus allograft is carefully prepared with structural bone plugs on both the anterior and posterior horns (trimmed to a depth of roughly 10mm). Suture tape loops are passed straight through the center of the bone plugs and into the body of the meniscus to serve as strong anchor lines.
- Implant Shuttling: Nitinol passing wires are routed through the posterior knee. The meniscus graft is passed down a split cannula, untangled, and slid into the joint space. The posterior bone plug is smoothly dunked down into its pre-drilled tibial socket and tensioned securely.
- Inside-Out & All-Inside Suturing: To secure the peripheral rim of the new meniscus to the native joint capsule, the surgeon utilizes an Arthrex ZoneSpecific inside-out needle navigator. He places multiple vertical mattress suture tapes (about 5 superiorly and 3 to 4 inferiorly). An all-inside suturing device is also deployed to reinforce the posterior horn fixation.
- Anterior Fixation & Final Checks: The posterior bone plug is locked down in the tibia. Turning to the front of the knee, Dr. Garcia places the 9mm anterior bone plug into a pre-drilled 10mm tunnel, securing it firmly with a 6.25mm SwivelLock anchor. The remaining inside-out sutures are tied off sequentially to draw the capsule tightly to the meniscus. Final probing verifies that the transplanted meniscus is anatomically aligned, taut, and stable without any signs of subluxation (shifting out of place).
