Lateral Meniscus Zip Lesion of Knee: Classification and Repair Methods

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Knee Anatomy

Background:

• Lateral meniscus posterior horn tears, specifically zip lesions, are meniscocapsular injuries often associated with anterior cruciate ligament (ACL) tears.
• These lesions are critical for knee stability, particularly during the pivot shift maneuver, due to their location in the lateral meniscus posterior horn.
• Untreated meniscocapsular posterior tears can lead to osteoarthritis, highlighting the need for effective diagnostic and treatment strategies.

Purpose of the Study:

• To classify zip lesions of the posterior horn of the lateral meniscus.
• To emphasize the importance of identifying these often-missed injuries.
• To describe surgical techniques for repairing these posterior horn tears.

Main Methods:

• Classification of zip lesions based on their location and characteristics.
• Diagnostic recommendations including arthroscopic exploration from the anteromedial portal to the posterolateral compartment.
• Description of various all-inside arthroscopic techniques for tear repair.

Main Results:

• Zip lesions are posterior meniscocapsular tears that can be overlooked during standard MRI and arthroscopy.
• A systematic approach from the anteromedial portal can aid in the identification of these "hidden" lesions.
• All-inside arthroscopic techniques provide viable repair options for these challenging tears.

Conclusions:

• Accurate classification and identification of zip lesions are essential for appropriate management.
• Preservation and repair of the lateral meniscus posterior horn are vital for preventing long-term knee degeneration, such as osteoarthritis.
• Arthroscopic all-inside repair techniques offer effective solutions for zip lesions, improving patient outcomes.