Repair of anterior meniscofemoral ligament-posterior horn junction tear of the lateral meniscus: a report of four different cases

Abstract

Lateral meniscus posterior horn tears are frequently associated with pivoting trauma and anterior cruciate ligament injuries, but they encompass heterogeneous and incompletely characterized patterns. We present four cases of tears at the junction of the anterior meniscofemoral ligament (MFL) and the posterior horn of the lateral meniscus. Two patterns were identified: an isolated tear and a combined tear associated with an oblique radial tear of the lateral meniscus. These lesions mimic root tears and are often not detected by magnetic resonance imaging and may compromise anterolateral rotational stability if unrecognized or neglected. Intraoperative diagnosis is established by probing-induced hypermobility of the posterior horn despite an intact-appearing root. Repairs are conducted using different types of all-inside approaches, restoring continuity at the MFL-root junction. Postoperative rehabilitation follows standard meniscal root repair protocols. In a consecutive series of four young, active patients with minimum 12-month follow-up, this technique yielded stable menisci, resolution of pain, and no reoperations or recurrent effusions. LEVEL OF EVIDENCE: V.

Keywords: Anterior cruciate ligament; Lateral meniscus; Meniscal root tear; Meniscofemoral ligament; Posterior horn.