36 patients with symptomatic recurrence after partial meniscectomy were included in this pilot randomized controlled trial and parallel preference study. 21 patients were randomized to either meniscal allograft transplantation or a physiotherapy program, while 15 patients chose their group as part of a preference study. Baseline demographics and treatment outcomes were similar between the randomized and non-randomized cohorts, which allowed for the data to be pooled and analyzed together. Patients were followed for 12 months and assessed using Knee Injury and Osteoarthritis Outcome Score (KOOS), the International Knee Documentation Committee (IKDC) score, the Lysholm score, and cartilage volume loss on MRI. Results demonstrated a significantly greater improvement in KOOS score in the meniscal allograft transplantation group compared to the physiotherapy group; no significant differences between groups were observed for other outcomes.