Abstract
An avulsion of the posterior tibial insertion of the lateral meniscus occurs during rotational distortion of the knee and can be associated with a tear of the anterior cruciate ligament (ACL). We performed a follow-up of 28 patients who, following anatomical ACL reconstruction using the ipsilateral semitendinosus graft, underwent either transosseous repair of the posterior lateral meniscus root (n=14) or no intervention (n=14). The meniscus root tears were classified as Forkel I lesions. All patients were examined 6 months after surgery and undertook scoring using International Knee Documentation Committee Score (IKDC). Comparing the repair group with the no repair group the subjective IKDC 6 months after surgery was 75,72% (±1,019) and 75,56 (±1,058). Regarding the objective IKDC 8 × A (57,1%) and 6 × B (42,9%) could be ascertained in the repair group whereas 6 × A (42,9%), 6 × B (42,9%), and 2 × C (14,3%) scoring could be ascertained in the no repair group. It remains unclear if surgery on type Forkel I PLMRT provides benefits compared to the nonsurgical procedures as in both groups stability might occur. The purpose of this article was to report the outcome of surgical repair of lateral meniscus root tears.
Highlights
Unlike posterior root tears of the medial meniscus which generally occur as a consequence of meniscal tissue degeneration and increased compartmental load, posterior lateral meniscus root tears (PLMRTs) usually occur following traumatic rotational distortion of the knee and are commonly associated with an anterior cruciate ligament (ACL) tear [1,2,3,4,5]
Three different classification systems have been published to describe the pattern of the posterior lateral meniscal root tear (PLMRT) and adjacent structures [2, 9, 10] such as the meniscofemoral ligaments (MFLs)
According to the classification published by Forkel and Petersen, Type I is an avulsion of the root at the plateau of the tibia with intact MFL, Type II is a radial tear of the posterior horn of the lateral meniscus with an intact MFL, and Type III is a complete injury of the posterior horn of the lateral meniscus with rupture of the MFL [9]
Summary
An avulsion of the posterior tibial insertion of either the medial or lateral meniscus is thought to be a relatively rare clinical diagnosis.Unlike posterior root tears of the medial meniscus which generally occur as a consequence of meniscal tissue degeneration and increased compartmental load, posterior lateral meniscus root tears (PLMRTs) usually occur following traumatic rotational distortion of the knee and are commonly associated with an anterior cruciate ligament (ACL) tear [1,2,3,4,5].Several studies have shown that approximately 1 out of 10 patients with ACL injury sustain a PLMRT [2,3,4, 6,7,8].Three different classification systems have been published to describe the pattern of the posterior lateral meniscal root tear (PLMRT) and adjacent structures [2, 9, 10] such as the meniscofemoral ligaments (MFLs).By definition meniscal root tears are specified as a radial tear of the meniscus tissue in close proximity (1 cm) to the insertion or an avulsion of the meniscotibial ligament (root ligament) [11].But the diagnosis can be missed in initial radiological and arthroscopic assessment and can often be diagnosed during arthroscopic ACL reconstruction. An avulsion of the posterior tibial insertion of either the medial or lateral meniscus is thought to be a relatively rare clinical diagnosis. Unlike posterior root tears of the medial meniscus which generally occur as a consequence of meniscal tissue degeneration and increased compartmental load, posterior lateral meniscus root tears (PLMRTs) usually occur following traumatic rotational distortion of the knee and are commonly associated with an anterior cruciate ligament (ACL) tear [1,2,3,4,5]. By definition meniscal root tears are specified as a radial tear of the meniscus tissue in close proximity (1 cm) to the insertion or an avulsion of the meniscotibial ligament (root ligament) [11].
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