Combined medial and lateral meniscal allograft transplantation with revision bone-patellar tendon-bone anterior cruciate ligament reconstruction for bicompartmental meniscal deficiency: a case report

Abstract

Symptomatic loss of meniscal tissue combined with anterior cruciate ligament (ACL) insufficiency is difficult to manage, particularly after previous failed surgery. We report a 22-year-old man with pain, recurrent effusions, and functional limitation after two prior arthroscopic procedures on the right knee, including failed bone-patellar tendon-bone (BTB) ACL reconstruction and subtotal meniscectomy. Preoperative magnetic resonance imaging and diagnostic arthroscopy demonstrated severe deficiency of both the medial and lateral menisci together with ACL insufficiency. The patient underwent single-stage combined medial and lateral meniscal allograft transplantation using fresh-frozen allografts and concomitant revision BTB ACL reconstruction. At 6 months, the knee was stable, range of motion was 0-130 degrees, International Knee Documentation Committee score was 92, Lysholm score 90, and there were no effusions, inflammatory signs, or graft-related complications. This case illustrates a joint-preserving single-stage option for young patients with bicompartmental meniscal deficiency and ACL insufficiency.