Popliteomeniscal Fascicle Tears

Abstract

Isolated popliteomeniscal fascicle tears are often unrecognized and misdiagnosed. Patients typically have vague symptoms and often-normal magnetic resonance imaging and physical examination findings. Isolated injuries are often misdiagnosed and mistreated, leading to delayed surgical treatment. Unrecognized tears can lead to continued disability, lateral meniscus tears, and chondral lesions. Appropriate diagnosis and treatment with inside-out lateral meniscus repair will allow the athlete to return to activity.

Hypermobile lateral meniscus: A systematic review of current treatment options

“…The oldest study was published in 1988 [33] and the newest one in 2023 [7] and more than half of the studies were from the past 10 years. Regarding the study design, all of the articles were descriptive, of which 12 studies were case reports [3,8,11,12,17,29,34,35,[40][41][42][43] and eight were case series [7,19,22,24,31,33,49,53]. Therefore, all studies had a level of evidence of IV according to the Oxford Center of Evidence-Based Medicine criteria.…”

“…HLM is usually underdiagnosed due to unspecific symptoms and often a normal physical examination and magnetic resonance imaging (MRI) of the afflicted patients [2,3,38,47]. Unlike routine knee examinations, which reveal no abnormalities, it is reported that placing the patient's knee in the figureof-4 position can reproduce the same symptoms, helping to confirm the HLM diagnosis [3]. In addition, MRI is usually interpreted as normal in HLM.…”

“…Arthroscopy is considered the gold standard for the diagnosis of an HLM, and arthroscopic assessment of hypermobility is considerably related to the experience of the surgeon [2,3,18,52]. Although there is no definite consensus, several studies have proposed that the diagnosis is confirmed when the LM is translated over 50% during arthroscopic probing [2,18].…”

“…Surgery is recognized as the treatment of choice in symptomatic patients with PMF injuries, due to a lower risk of recurrence compared to alternatives [52]. Failing to timely diagnose and treat these injuries can lead to complex and permanent meniscal insufficiencies, long-lasting dysfunction and articular cartilage damage [3,16]. There is no reliable recent data on the incidence of these injuries due to vague and challenging diagnostic methods up until the recent advancements in arthroscopic techniques [1].…”

Menisco Lateral Hipermóvil: Diagnóstico y Tratamiento de Lesiones de Fascículos Poplíteo Meniscales

“…A pesar de los avances en el conocimiento de este tipo de lesiones, la evaluación mediante artroscopia sigue siendoen la actualidad el gold standard para el diagnóstico de certeza, puesto que permite una visualización directa de los fascículos poplíteo-meniscales y la evaluación de la movilidad del menisco lateral. 13 Existen múltiples técnicas quirúrgicas publicadas para el tratamiento de este tipo de patología: meniscectomía, 14 reduccióntérmica meniscal, 15,16 reparación con sutura meniscal en forma abierta 9 y artroscópica, 17,18 además reconstrucción de fascículos poplíteomeniscales con utilización de injerto. 1 Dado lo poco frecuente del Síndrome de Menisco Hipermóvil, el propósito de esta publicación es describir nuestra experiencia en el diagnóstico y tratamiento de este tipo de lesiones dentro de un grupo de traumatólogos especialistas en rodilla, en relación a 9 casos clínicos.…”