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Dr. Garcia demonstrates his technique for a lateral meniscus transplant using the dovetail technique.
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 lateral meniscus transplantation using the specialized Arthrex dovetail technique. This approach relies on a contoured bone bar matching a precision-cut slot in the tibia to provide stable fixation for the new allograft.
The procedure follows these primary steps:
- Joint and Tunnel Preparation: The surgeon performs a minor notchplasty to fully visualize the posterior root of the lateral side and the back wall of the tibia. He debrides the torn native meniscus, leaving a 1–2mm capsular rim for vascular in-growth, and uses a bone burr followed by sequential 6mm and 7mm reamers to carve a precise bone trough (or slot) that follows the natural posterior slope of the tibial plateau.
- Graft Contouring: On the back table, the cuboid bone block attached to the donor lateral meniscus is carefully sculpted. Dr. Garcia cuts the block to align evenly with the joint surface and shapes it into a tailored dovetail geometry so that it sits completely flush once inserted into the tibial slot. A horizontal suture tape is passed through the posterior aspect of the meniscus to act as a pull/passing line.
- Shuttling and Reduction: Using passing wires and an accessory posterolateral incision (with a surgical spoon to protect deep nerves and vessels), the suture tapes are routed out of the knee. The sculpted bone dovetail is slotted directly into the prepared tibial trough, and the body of the new meniscus is easily pulled and reduced into its anatomical position under arthroscopic visualization.
- Fixation and Stabilization: The surgeon employs an all-suture, all-inside device to securely lock the posterior horn of the transplant to the joint capsule. He then switches to an inside-out technique using a zone-specific cannula to place multiple vertical mattress sutures (3 to 4 superiorly and 3 to 4 inferiorly) along the peripheral rim.
- Interference Fit Fitment: Upon final probing, if any minor movement or micro-gapping is noted within the bone trough, Dr. Garcia inserts a 4.75mm SwivelLock anchor to act as an interference wedge, securely locking the dovetail block and completing a completely stable, rigid structural reconstruction.
