The 'Floating Medial Meniscus' Lesion in KD3M Knee Dislocations.

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Knee Injuries

Background:

• High-energy knee dislocations can cause unusual meniscal tears, termed 'floating medial meniscus' lesions.
• These lesions involve avulsion of both anterior and posterior roots of the medial meniscus with extra-articular displacement.
• This specific tear pattern has been occasionally observed in severe knee injuries.

Purpose of the Study:

• To define the 'floating medial meniscus' lesion.
• To report its incidence in multiple ligament knee injuries.
• To assess the impact of surgical timing and evaluate repair outcomes.

Main Methods:

• Retrospective analysis of 341 multiple ligament knee injury surgeries (2008-2022).
• Identification of cases with floating medial meniscus lesions.
• Combined arthroscopic and open medial approach for one-stage repair; early intervention defined as surgery within 3 weeks.

Main Results:

• Seven patients (all male, mean age 27.2) identified with floating medial meniscus lesions.
• Preoperative MRI was effective in lesion identification.
• Early surgery (5 patients) facilitated easier repair; delayed surgery (2 patients) presented challenges.
• All patients achieved 0-130° ROM, no instability/pain, healed meniscal roots on MRI, and a mean IKDC score of 89.5.
• Two elite athletes returned to their previous sports level.

Conclusions:

• Floating medial meniscus lesions, though complex, are repairable with a systematic surgical approach.
• Satisfactory functional outcomes and return to sport are achievable.
• Early surgical intervention simplifies meniscus dissection, reduction, and repair, leading to better results.