Characteristics of Posterior Root Tears of the Lateral Meniscus

Lateral meniscus posterior root tears are increasingly recognized as clinically important injuries that can compromise meniscal function and alter knee joint biomechanics, particularly in the setting of anterior cruciate ligament (ACL) injury. This review synthesizes and critically evaluates the current literature on the anatomy, biomechanics, classification, epidemiology, diagnosis, and management of lateral meniscus posterior root tears, with consideration of similarities and differences compared with medial meniscus posterior root tears. Particular attention is given to the anatomical relationship of the lateral meniscus posterior root to the tibial plateau and adjacent structures, as well as to the biomechanical consequences of root disruption, including impaired load transmission, increased compartmental contact stresses, and potential effects on knee stability. Current classification approaches and diagnostic strategies are evaluated for their clinical applicability and limitations. The review further examines contemporary surgical management, focusing on arthroscopic anatomic root repair, repair techniques, patient- and injury-related factors influencing treatment selection, and the extent to which restoration of the native root attachment may improve meniscal function and knee mechanics. Available evidence regarding postoperative rehabilitation, complications, and clinical outcomes is also critically assessed. Particular consideration is given to the frequent coexistence of lateral meniscus posterior root tears with acute ACL injuries and the implications of an unrecognized or untreated root injury for joint stability and long-term meniscal preservation. By integrating anatomical, biomechanical, clinical, and surgical evidence, this review highlights current areas of consensus, limitations in the literature, and priorities for future research to improve diagnosis, treatment strategies, and patient outcomes.