The Anterior Horn Pull-In Tunnel Technique for Managing Oversized Grafts in Lateral Meniscal Allograft Transplantation.

An oversized graft in lateral meniscal allograft transplantation can lead to graft extrusion, folding, and increased contact stress, adversely affecting surgical outcomes. To address this challenge, this article describes an anterior horn pull-in tunnel technique applicable to the bone plug fixation method. The key step of this technique involves, upon intraoperative identification of an oversized graft, arthroscopically advancing the anterior bone plug further into the tibial tunnel, drawing a portion of the meniscal tissue into the tunnel. This effectively reduces graft redundancy within the joint, eliminates folding, and restores the synovial margin to its normal position at the tibial plateau edge. This straightforward technique provides an effective intraoperative solution for adjusting graft size and optimizing fit without compromising the advantage of bone-to-bone healing.