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A lateral meniscus tear incarcerated behind the popliteus tendon: a case report
Mark S Eskander1, Jacob M Drew, Daniel B Osuch
1Department of Orthopedic Surgery, University of Massachusetts Medical School, Worcester, Massachusetts 01655, United States. eskanm01@ummhc.org
Abstract:
A 51-year-old male, sustained an injury to his left knee after being pinned between his motorcycle and a road barrier. In the ER, the patient complained of medial knee pain, and had a significant joint effusion. MRI demonstrated an ACL injury, medial meniscal tear, bone bruising and impaction at the lateral femoral condyle and tibial plateau, and a tear of the posterior horn of the lateral meniscus that was displaced behind the popliteus. Unfortunately, the patient also presented with a deep vein thrombosis and thus could not proceed to the operating room for two months. During this time, scar tissue developed around the lateral meniscus. The purpose of this report is to present an unusual variant of a common injury pattern previously unreported where the posterior horn of the lateral meniscus became incarcerated behind the popliteus tendon and was left in place. It is likely that our patient will develop osteoarthritis in the future, but considering the circumstances he received a favorable early clinical outcome. Early recognition and a mobile fragment are essential restoring a patient's original anatomical features and achieving an optimal clinical outcome.
Insights
A motorcycle accident caused a rare knee injury where the lateral meniscus lodged behind the popliteus tendon. Delayed surgery led to scarring but a favorable early outcome for this ACL and meniscal tear patient.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Trauma Surgery
Background:
- A 51-year-old male sustained a complex left knee injury involving anterior cruciate ligament (ACL) tear, medial meniscus tear, and bone impaction.
- Magnetic Resonance Imaging (MRI) revealed a displaced tear of the posterior horn of the lateral meniscus, lodged behind the popliteus tendon.
Observation:
- The patient developed deep vein thrombosis (DVT), necessitating a two-month delay before surgical intervention.
- Scar tissue formation around the incarcerated lateral meniscus occurred during the delay.
Findings:
- This case presents an unusual variant of a common knee injury pattern: incarceration of the lateral meniscus posterior horn behind the popliteus tendon.
- Despite the delay and scar tissue, the patient achieved a favorable early clinical outcome.
Implications:
- Early recognition and management of displaced meniscal fragments are crucial for optimal patient outcomes.
- This case highlights a rare complication and emphasizes the importance of timely surgical intervention in complex knee injuries.
- Future development of osteoarthritis is anticipated, underscoring the long-term implications of such injuries.
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