Arthroscopic Diagnosis and All-Inside Repair of Meniscofibular Ligament Tear

Meniscofibular ligament (MFL) tears are an under-recognized source of lateral meniscal instability, frequently encountered in association with anterior cruciate ligament injury. Failure to identify and address MFL insufficiency may result in persistent posterolateral pain and meniscal hypermobility despite successful anterior cruciate ligament reconstruction. This Technical Note describes a reproducible, all-inside arthroscopic technique for the diagnosis and repair of MFL tears. Diagnostic arthroscopy includes systematic evaluation of the popliteal hiatus and posterolateral gutter, with dynamic probing of the lateral meniscus and identification MFL tear. The repair is performed through standard anterior portals, using all-inside vertical sutures to re-establish continuity between the MFL stump, the inferior border of the posterolateral meniscus, and the posterolateral capsule. This technique allows an anatomic, meniscus-preserving repair without additional open dissection or hardware in the fibular head. It is reproducible with standard arthroscopic equipment and can be combined with concomitant anterior cruciate ligament reconstruction.