Reconstruction of the Popliteomeniscal Fascicles for Treatment of Recurrent Subluxation of the Lateral Meniscus

Suganuma, Jun; Inoue, Yutaka; Tani, Hideaki; Sugiki, Tadashi; Sassa, Takafumi; Shibata, Reo

doi:10.1016/j.eats.2016.09.034

Cited by 9 publications

(11 citation statements)

References 25 publications

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“…PMFs, connecting the lateral meniscus at the popliteal hiatus [ 13 ], are thought to provide stability to the lateral meniscus, stabilizing the joint during internal rotation of the tibia and sudden changes of direction (Fig. 1 ) [ 4 , 14 – 17 ]. In particular, working in conjunction with the popliteus musculotendinous unit, the PMFs prevent excessive lateral meniscal movement and possible entrapment [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

The popliteomeniscal fascicles: from diagnosis to surgical repair: a systematic review of current literature

et al. 2021

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Background Popliteomeniscal fascicles (PMF) are considered the posterolateral meniscocapsular extensions which connect the lateral meniscus to the edge of the tibia. PMFs disruption leads to hypermobility of the lateral meniscus with pain and locking sensation. Recognition and treatment of PMFs tear remain very challenging. The aim of this systematic review is to collect and analyse the articles concerning popliteomeniscal fascicle disruption from diagnosis to surgical approach. Methods PubMed, Scopus, Web of Science and EMBASE were searched. Various combinations of the keywords “Popliteomeniscal Fascicles”, “Lateral Meniscus”, “Popliteal Hiatus”, “Posterolateral Corner”, “Tear” and “Surgical Repair” were used. The original literature search identified a total of 85 articles comprising of duplicates. The PRISMA guidilines were followed. Studies in English language and published in peer-reviewed journals were included. Articles with level of evidence I to IV were included Results A total of three articles were included in the qualitative analysis. All the articles included are retrospective case series, with a level of evidence IV. Studies concerning patients with pre-operative imaging MRI and clinical assessment, reporting surgical technique and clinical outcomes assessed by physical examination and/or subjective evaluation scales were analysed. Conclusions MRI and the Figure-4 test allow to assess PMF tears pre-operatively. Arthroscopic evaluation constitutes the gold standard to confirm the diagnosis. Although surgery is considered resolutive for symptoms, there is still controversy about the most appropriate technique. Further higher quality studies are required.

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Section: Introductionmentioning

confidence: 99%

The popliteomeniscal fascicles: from diagnosis to surgical repair: a systematic review of current literature

et al. 2021

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“…The loose attachment of the lateral meniscus to the capsule is interrupted by the popliteal hiatus [ 9 , 26 ]. At the popliteal hiatus, three PMFs (i.e., anteroinferior, posterosuperior, and posteroinferior) [ 8 , 18 , 27 ], along with the popliteus tendon, attach to the lateral meniscus [ 10 ]. These PMFs prevent the anterior displacement of the posterolateral corner of the lateral meniscus during knee flexion [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Repair of popliteomeniscal fascicles tear using a posterior transseptal portal fixes hypermobile lateral meniscus

et al. 2021

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Purpose This study investigates the effects of the all-inside repair of posterosuperior popliteomeniscal fascicle (PMF) on lateral meniscus stabilization using a posterior arthroscopic approach. Methods Between 2015 and 2018, 17 patients with hypermobile lateral meniscus (HLM) underwent posterior knee arthroscopy for PMF repair. The all-inside repair was performed through posteromedial transseptal and posterolateral portals using a suture hook technique. Patients were clinically assessed based on IKDC and Lysholm scores. Results Both IKDC and Lysholm scores improved significantly after an average follow-up of 3.5 years (P < 0.001). No patients underwent reoperation, and no complications associated with posterior knee arthroscopy were reported. Conclusion The all-inside suture hook technique using posterolateral and posteromedial transseptal portals fixes HLM with excellent IKDC and Lysholm scores. Level of evidence Level IV.

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“…At present, there are only a few reports of meniscal lesions involving the popliteal hiatus in nondiscoid meniscus, including PMF injury [2, 10, 21, 25, 28], injuries at the medial edge of the popliteal hiatus, and tears of the anterior and posterior aspects of the popliteal hiatus [2]. These injuries lead to recurrent subluxation and hypermobility of the lateral meniscus and mechanical symptoms including lateral knee pain, locking, and snapping [9, 12].…”

Section: Introductionmentioning

confidence: 99%

Widening of the popliteal hiatus on magnetic resonance imaging leads to recurrent subluxation of the lateral meniscus

Zhao

Dai

et al. 2019

Knee Surg Sports Traumatol Arthrosc

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Purpose This study was undertaken to elucidate the clinical significance of widening of the popliteal hiatus on magnetic resonance imaging (MRI), and to document the clinical results and technical aspects of arthroscopic repair of this finding. Methods Included are 82 knees after arthroscopic surgery, divided according to arthroscopic diagnosis into group A, hypermobility of lateral meniscus, 8 knees; group B, tear of the anterior horn of the lateral meniscus, 32 knees; and group C, no abnormality of the lateral meniscus, 36 knees with medial meniscal tears and 6 with other conditions. Popliteal hiatus diameter was measured and the popliteal hiatus/lateral tibial plateau (LTP) ratio was calculated on preoperative sagittal and coronal MRI. At arthroscopy, the widened popliteal hiatus in group A was tightened anteriorly by outside-in or all-inside suture and posteriorly with all-inside suture. Outcomes were evaluated with MRI, Lysholm, Tegner and VAS scores. ResultsThe preoperative diameter of the popliteal hiatus and the popliteal hiatus/LTP ratio were significantly larger in group A than in groups B and C (p < 0.05) on both views. Threshold popliteal hiatus/LTP values of 0.16 and 0.18 on the sagittal and coronal views demonstrated diagnostic discrimination, and these values were significantly reduced after arthroscopy in Group A. Lysholm and Tegner scores were improved after tightening of the popliteal hiatus, while VAS scores reduced (all p < 0.05). Conclusion Widening of the popliteal hiatus on MRI may lead to recurrent subluxation of the lateral meniscus. Arthroscopic anterior and posterior tightening of the popliteal hiatus was a safe and effective treatment. Level of evidence II.

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Reconstruction of the Popliteomeniscal Fascicles for Treatment of Recurrent Subluxation of the Lateral Meniscus

Cited by 9 publications

References 25 publications

The popliteomeniscal fascicles: from diagnosis to surgical repair: a systematic review of current literature

The popliteomeniscal fascicles: from diagnosis to surgical repair: a systematic review of current literature

Repair of popliteomeniscal fascicles tear using a posterior transseptal portal fixes hypermobile lateral meniscus

Widening of the popliteal hiatus on magnetic resonance imaging leads to recurrent subluxation of the lateral meniscus

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