Tears of the Popliteomeniscal Fascicles of the Lateral Meniscus: An Arthroscopic Classification

Objective To bring forward an arthroscopic classification of the popliteomeniscal fascicles of the lateral meniscus (PFLM) tears. Design Six fresh frozen knee joint samples of adult males were chosen, and the lateral meniscus at the popliteal hiatus region were measured to analyze their anatomic relationship. Patients who had received magnetic resonance imaging scan at knee joint before the surgery and diagnosed as PFLM tears by arthroscopy from April 2014 to October 2017 were selected. Data regarding the integrity of PFLM were prospectively recorded in a data registry. Tear morphology and treatment received were subsequently extracted by 2 independent reviewers from operative notes and arthroscopic surgical photos. Results The average length and thickness of the popliteal hiatus of the lateral meniscus were 2.09 +/- 0.21 cm and 0.43 +/- 0.08 cm, respectively. The average length of anterosuperior popliteomeniscal fascicle (APF) was 0.87 +/- 0.18 cm, and the posterosuperior popliteomeniscal fascicle (PPF) was 0.72 +/- 0.15 cm. A total of 36 PFLM tears in 36 patients were divided as type I (APF tear; n = 5, 13.9%), type II (PPF tear; n = 20, 55.6%), and type III (both APF and PPF tears; n = 11, 30.6%). All patients were treated with arthroscopic all-inside repair using a suture hook for the PFLM tears and follow-up for 21.1 months. All patients have done well with significantly improved Lysholm and International Knee Documentation Committee scores at the last follow-up relative to preoperative scores (P < 0.01). Conclusion This study suggests to possibly classify the PFLM tears for clinical practice.