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Dr. Garcia’s updated technique for ACL with medialmeniscus transplant surgery
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 his updated technique for performing a medial meniscus transplant concurrently with an ACL reconstruction. This modified protocol is specifically designed to eliminate the risks associated with bone tunnels crowding each other anteriorly.
The specialized surgical process includes:
- Posterior Root & Capsular Tensioning: The procedure utilizes a bone plug technique for the posterior aspect of the medial meniscus transplant. Once the posterior root is dunked, but before adding all-inside stitches, Dr. Garcia passes multiple heavy tapes in a vertical mattress fashion. This established step secures the posterior capsular tension first.
- Anterior Soft Tissue Root Fixation: Rather than a traditional anterior bone plug—which carries a high risk of breaking out into the adjacent ACL tunnel—Dr. Garcia transitions to an anatomically guided soft tissue fixation for the anterior root. A SwivelLock anchor is placed to fixate the anterior root, creating a highly natural contour along the tibia.
- Anterior Horn Suture & Alignment: Following the tensioning of the root, additional sutures are placed in the anterior horn. The capsule and the meniscus are brought together toward a mid-point anteriorly, and all-inside FiberStitches are placed posteriorly in either a single or crisscross fashion to lock the graft into its permanent bed.
- ACL Reconstruction & Final Check: A quadriceps tendon autograft is used for the ACL reconstruction, fixated with two buttons. The final look shows a stable knee with zero laxity on a Lachman test. The transplanted meniscus sits in an ideal, anatomic position with no extrusion, ready to scar down securely in the front.
