Cutting Edge Orthopedics - Issue 3

44 • CUTTING EDGE - ORTHOPEDICS Conclusion The described arthroscopic meniscus suture technique is effective for treating symp- tomatic recurrent subluxation of the lateral meniscus without any complications or recurrence. Clinical suspicion and understanding of recurrent subluxation with lateral meniscus are impor- tant to diagnose the disease especially when definite meniscal tear signs are absent on magnetic resonance imaging. Level of evidence IV. Keywords: Knee, Lateral meniscus, Posterior horn, Popliteal hiatus, Meniscus repair, All-inside suture Introduction The lateral meniscus is circular in shape, smaller in radius, and more mobile than the medial menis- cus because it has a loose attachment to the capsule, which is interrupted by the popliteal hiatus [28, 34]. Although the posterior horn of the lateral meniscus is more susceptible to subluxation than the medial meniscus, subluxation of the lateral meniscus is less frequently reported than that of the medial meniscus [7, 11, 13, 14, 22, 23, 35]. A displaced lateral meniscus is spontaneously reduced, and typically characterized by only intermittent locking symptoms without definite tear signs on magnetic resonance imaging (MRI) [10, 23, 27, 32]. The diagnosis of lateral meniscus hypermobil- ity without subluxation is difficult without thorough understanding of the lateral meniscus and high clinical suspicion of hypermobility even during arthroscopic examination, because tears of the popliteomeniscal fascicle are rare and shrouded in the parameniscal region [20, 23, 24, 33]. The nomenclature regarding such injuries varies, including recurrent subluxation of the lateral meniscus, popliteomeniscal fascicle tear, hypermobile posterior horn of lateral meniscus, and MRI-negative bucket-handle tears of the lateral meniscus [5, 13, 14, 16, 20, 21, 23, 24, 29]. Various treatments for recurrent subluxation of the lateral meniscus have been advocated, such as open repair of the popliteomeniscal fascicles of the lateral meniscus, arthroscopic subtotal meniscec- tomy, arthroscopic meniscus repair, and thermal shrinkage of the posterolateral capsule [14, 17, 19, 20]. With the advent of improved arthroscopic techniques, current treatment recommendations favor meniscal preservation through different arthroscopic repair techniques [2, 3, 6, 9, 15, 26]. Several case reports examining the recurrent subluxation of lateral meniscus concentrated on the diagnosis or results obtained from arthroscopy [13, 14, 24]. However, few follow-up clinical studies following arthroscopic treatment for the recurrent subluxation of lateral meniscus have been undertaken [32]. Therefore, the purpose of this study was to document clinical results and the technical aspects of arthroscopic meniscus repair for recurrent lateral meniscus subluxation. In this current study, it was hypothesized that arthroscopic meniscus repair would yield satisfac- tory clinical results without recurrence of symptomatic recurrent subluxation. Materials and Methods Thirty-nine patients (40 knees) were treated with a modified arthroscopic technique to repair tears of the popliteomeniscal fascicle of normally-shaped lateral meniscus from March 2004 to

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