Loss of the lateral meniscus at a young age may predispose to early development of symptomatic valgus. Historically a femoral osteotomy has been undertaken to correct this. However, this only corrects valgus in the extended position.

Meniscus allograft transplantation is now more acceptable as evidence of mid- and long-term benefits has become available. In patients with pain and malalignment, meniscus allograft transplantation combined with a high tibial osteotomy may be performed.

We describe a series of 5 patients aged 21 – 47 with very good outcomes at minimum follow up of 14 months. Improvements were seen from pre-operative to 12 months post-operative in Lysholm 51.7 (31-65) to 88.3 (86-91), Oxford 38.7 (37 – 40) to 45 (44-46) and in all scales of the KOOS score.

The technical considerations of a lateral opening wedge high tibial osteotomy combined with lateral meniscus allograft transplantation in young patients is discussed.

This combined procedure is indicated in symptomatic young patients who are in valgus alignment requiring up to 6 degrees correction and a knee in which the articular cartilage is amenable to meniscal transplantation.