Repair Technique for Displaced Meniscal Flap Tears Indicated by MRI Comma Sign

The meniscus comma sign has been described for displaced flap tears of the meniscus. These meniscus tears are displaced into the tibia or femoral recesses and can be often difficult to diagnose intraoperatively. We describe the technique of diagnosis and treatment of a large displaced lateral meniscus flap tear, presenting as a meniscus comma sign. The identification of the meniscus comma sign on consecutive magnetic resonance imaging (MRI) cuts suggest a flap tear of a significant size that indicates reparability. The technique would be to lift the meniscus flap from the meniscotibial recess, reduce it and then repair it with an all-inside meniscus repair or by hybrid meniscus repair techniques.