Popliteomeniscal fascicles tear with lateral meniscus instability : arthroscopic all-inside technique with two-year follow-up

Abstract

Background

The popliteomeniscal fascicles (PMFs) connect the lateral meniscus to the popliteal hiatus and provide stability to the lateral meniscus. A high percentage of knees with acute and chronic anterior cruciate ligament (ACL), posterolateral corner injuries and/or hypermobile lateral meniscus (HLM) have concurrent damage to the PMFs. The present study evaluated the outcome of a two-year follow-up of an all-inside arthroscopic procedure to manage tears of the PMFs associated with lateral meniscus instability. Methods

A total of 11 patients with a tear of the PMFs diagnosed clinically and at MRI underwent an all-inside arthroscopic repair. Patients were enrolled prospectively and evaluated using the Tegner, Lysholm, and IKDC scales for two years. Main findings

The post-operative MRI revealed that the PMFs had been successfully repaired arthroscopically. According to the subjective IKDC score (p < 0.05), the Lysholm score (p < 0.001), and the Tegner activity scale (p < 0.001), comparing pre-operative and post-operative values, all patients showed significant improvement at the two-year follow-up. Principal conclusions

Tears of the PMFs predispose the lateral compartment of the knee to chondral lesion, lateral meniscus instability, and progression of osteoarthritis. This study represents the largest series of all-inside repair techniques for PMF disruption. At two-year follow-up, all patients had improved clinically, without any giving way sensation during rotational movements. Most of them had returned to their pre-injury level of activity.