Allograft Transplants of the Extremities

Aetna covers knee allograft transplants (knee ligaments—ACL, PCL, MCL, LCL, MPFL—osteochondral grafts of the femoral articulation, and meniscal allografts) and deems the Fast-Fix meniscal repair system medically necessary. Coverage requires meeting specific selection criteria (e.g., osteochondral lesions must be full‑thickness grade 3–4 ≥2 cm with surrounding healthy cartilage, disabling pain refractory to conservative care, normal or surgically correctable alignment, stable knee with intact meniscus; meniscal allografts require age <55, minimal degeneration [Outerbridge ≤2], imaging showing absent/near‑absent meniscus, stable or corrected knee, and failed conservative therapy), and all other indications and listed products (e.g., Cartiform, DeNovo, Chondrofix, cryopreserved arterial allografts) are experimental/investigational.

"Chronic instability of knee [including lateral, medial, anterior and posterior ligaments] (ICD-10: M23."