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Published on: October 20, 2023
Popliteomeniscal fascicles tear with lateral meniscus instability: arthroscopic all-inside technique with two-year
Vico Di Giovanni1, Simonetta Roberto2, D'Addona Alessio3
1Department of Orthopaedics and Trauma Surgery, Clinica San Michele, Maddaloni, Caserta, Italy.
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.
