Snapping Knee Caused by a Popliteomeniscal Fascicle Tear of the Lateral Meniscus in a Professional Taekwondo Athlete

Abstract

A 19-year-old male professional Taekwondo athlete presented with a 2-year history of pain-free snapping of his right knee. He reported that his right knee joint gave way during games and training and that he could induce pain-free snapping between the proximal-to-fibular head and the lateral knee joint line. None of these physical findings suggested a meniscal pathology or ligamentous instability. Routine radiographs were normal. Magnetic resonance imaging of his right knee joint showed that the shape of the lateral meniscus was normal, and no lateral meniscus tears existed. On arthroscopic examination, popliteal hiatus view showed a posterosuperior popliteomeniscal fascicle tear between the posterior horn of the lateral meniscus and the posterior joint capsule just posteromedial to the popliteus tendon. With medial traction by probing, this popliteomeniscal tear made visible the significant subluxation of the posterior horn of the lateral meniscus to the center or anterior half of the tibial plateau. Based on the diagnosis of a posterosuperior popliteomeniscal tear of the right knee, Fast-Fix (Smith & Nephew, Andover, Massachusetts) was used for the direct repair of the peripheral portion of the lateral meniscus and joint capsule, targeting the popliteomeniscal junction. At 24 months postoperatively, the patient was performing athletic exercises relevant to his profession and was taking part in Taekwondo games, with no pain or recurrence of snapping. To the authors' knowledge, this is the first report of snapping of the lateral aspect of the knee due to a popliteomeniscal fascicle tear.

Instabilité méniscale par subluxation récurrente de la corne postérieure du ménisque latéral

“…Le diagnostic peut être fait en arthroscopie en reproduisant la subluxation du segment postérieur du ménisque latéral. Cependant, seulement quelques études [1][2][3][4][5][6][7][8][9][10][11] ont signalé cette entité, et les caractéristiques physiopathologiques et cliniques de la SRML n'ont pas encore été entièrement élucidées. Anatomiquement, le segment postérieur du ménisque laté-ral est relativement mobile par rapport à celui du ménisque médial mais la racine reste bien fixée.…”

“…Elles peuvent entraîner des blocages itératifs lorsque la partie mobile se luxe sous le condyle. Elles ont été décrites de façon relativement récente dans la littérature, sans que la physiopathologie ne soit complètement identifiée [1][2][3][4][5][6][7][8][9][10][11].…”

Semitendinosus snapping: analysis of movement, electromyographic activities, muscle strength and endurance, motor control and joint position sense

“…Snapping syndrome is defined as a feeling of tendon snapping or popping while performing an activity and mostly seen in the athletes [1][2][3][4][5][6][7] . Although snapping knee syndrome is a rare seen condition, this can lead to disabling problems [1][2][3][4]6,8 .…”

Natural evolution of popliteomeniscal fascicle tears over 2 years and its association with lateral articular knee cartilage degeneration in patients with traumatic anterior cruciate ligament tear

“…Mechanisms of injury can involve a single traumatic event or an insidious onset after repeated microtrauma [4,6].…”