Repair of popliteomeniscal fascicles tear using a posterior transseptal portal fixes hypermobile lateral meniscus

Sohrab Keyhani,Morteza Kazemi,Mohamad Qoreishy,Rene Verdonk,Mehran Soleymanha,Mohammad Movahedinia

doi:10.1186/s40634-021-00412-4

Abstract

PurposeThis study investigates the effects of the all-inside repair of posterosuperior popliteomeniscal fascicle (PMF) on lateral meniscus stabilization using a posterior arthroscopic approach.MethodsBetween 2015 and 2018, 17 patients with hypermobile lateral meniscus (HLM) underwent posterior knee arthroscopy for PMF repair. The all-inside repair was performed through posteromedial transseptal and posterolateral portals using a suture hook technique. Patients were clinically assessed based on IKDC and Lysholm scores.ResultsBoth IKDC and Lysholm scores improved significantly after an average follow-up of 3.5 years (P < 0.001). No patients underwent reoperation, and no complications associated with posterior knee arthroscopy were reported.ConclusionThe all-inside suture hook technique using posterolateral and posteromedial transseptal portals fixes HLM with excellent IKDC and Lysholm scores.Level of evidenceLevel IV.

Highlights

Hypermobile lateral meniscus (HLM) occurs following the disruption of the popliteomeniscal fascicles (PMF), the most frequent cause, near the popliteal tendon [1, 2]
The purpose of this study is to evaluate the role of posterior knee arthroscopy in the all-inside repair of HLM using the suture hook technique
The diagnosis was confirmed by surgery, as there was no evidence of PMF tearing from their magnetic resonance imaging (MRI) scans

Summary

Introduction

Hypermobile lateral meniscus (HLM) occurs following the disruption of the popliteomeniscal fascicles (PMF), the most frequent cause, near the popliteal tendon [1, 2]. In the case of HLM, the posterior portion of the lateral meniscus shows forward abnormal translation with knee flexion and backward translation with knee extension, opposing its physiological motion [3]. A displaced lateral meniscus can be spontaneously reduced without any obvious tears observed via Surgical HLM treatment is generally recommended only for patients whose symptoms have not improved with conservative treatment [12, 13]. Different treatments have been proposed for the recurrent subluxation of the lateral meniscus, including arthroscopic subtotal meniscectomy or meniscus repair and thermal shrinkage of the posterolateral capsule [4, 10, 14, 15].

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