Editorial Commentary: If the Lateral Meniscus Is Hypermobile, Repair It

A hypermobile lateral meniscus remains an important and underappreciated cause of lateral compartment knee pain despite increasing understanding of the complex anatomy surrounding the popliteal hiatus. Recent anatomic and histologic studies continue to refine knowledge of the meniscofibular ligament and the popliteomeniscal fascicle, but microscopic anatomy alone should not dictate surgical decision-making. Histologic evidence of ligamentous tissue does not establish biomechanical function nor validate tear repair techniques. The priority in symptomatic lateral meniscus instability should remain restoration of native meniscal anatomy through anatomic repair, regardless of which individual fascicle or ligament is involved in the tear pattern. Equally important is recognition of the normal mobility of the popliteal hiatus to avoid iatrogenic overconstraint during repair. As our understanding of this region evolves, the clinical message remains straightforward. If the lateral meniscus is hypermobile, repair it, preserve it, and avoid meniscectomy wherever possible.