HYPOTHESIS: Osteochondral defects of the carpometacarpal (CMC), metacarpophalangeal (MCP), and proximal interphalangeal (PIP) joints often necessitate joint arthrodesis or mechanical arthroplasty. Cadaveric meniscus has long been used for large joint resurfacing,1,2 but its application to smaller joints of the hand is less well understood. In severely arthritic thumb and finger joints, we propose the use of cadaveric meniscus for joint resurfacing as an off-the-shelf alternative to address osteochondral defects and restore articular function. METHODS: Thirty-six patients with osteoarthritis of the CMC, MCP, or PIP joints underwent joint resurfacing with cadaveric meniscus. Patient demographics and operative information were recorded. Postoperative Disability of the Shoulder, Arm and Hand scores, Wong-Baker pain scale score, grip strength, and pinch strength were compared to preoperative scores at 6 weeks and 6 months. RESULTS: Twenty-one females and 15 males, with mean age of 56.7 years (42–73), underwent a total 43 joint reconstructions. Reconstructive sites included thumb carpometacarpal joint (n = 21), thumb metacarpal joint (n = 2), thumb interphalangeal joint (n = 2), digit metacarpal joint (n = 3), and digit proximal interphalangeal joint (n = 2). Mean Disability of the Shoulder, Arm and Hand score decreased from an average of 39.2 (16–91) to 22.7 (3–55) at 6 months and pain scale scores decreased from an average of 6.5 (4–10) to 1.6 (0–4). Grip strength increased from 38.7 (3–84) to 44.5 (8–94) and pinch increased from 10.3 (1–19) to 10.7 (2–20). There were no complications related to the meniscus, and no patients required revision surgery. CONCLUSION: In this series of 42 joint reconstructions, we demonstrate the successful use of cadaver meniscus in hand joint arthroplasty to reduce subjective pain and disability scores, as well as to improve objective strength measures, including grip and pinch strength. Our early results suggest that cadaveric meniscus for small joint arthroplasty represents a viable joint salvage option or adjunct to preserve pain-free motion and avoid total joint arthrodesis. REFERENCES: 1. Rosso F, Bisicchia S, Bonasia DE, et al. Meniscal allograft transplantation: a systematic review. Am J Sports Med. 2015;43:998–1007. 2. Kang RW, Lattermann C, Cole BJ. Allograft meniscus transplantation: background, indications, techniques, and outcomes. J Knee Surg. 2006;19:220–230.