This is a relatively infrequently performed procedure but one that can be effective as a joint preserving strategy in selected patients. It is considered in younger patients who have severe meniscal damage or insufficiency as a result of very large or numerous previous meniscal tears who have persistent pain and who have already developed some early degeneration or at high risk of doing so. It aims to relieve pain and to preserve the articular cartilage from wear/further wear by restoring the “shock absorbing” effect of the meniscus. It involves transplanting a whole meniscus of carefully chosen size that has been obtained from the transplant tissue bank. The procedure can be performed arthroscopically (through key-hole surgery) although sometimes an open operation is required. The transplanted meniscus has small bone blocks at each end to allow anchorage to the recipients (patient receiving transplant) bone and further stability is gained by stitching the transplanted meniscus to the inside of the knee joint. As with all soft tissue transplants, over time the cells of the recipient grow into the graft so that it is eventually fully or nearly fully replaced by the recipients tissue.