Hypermobile lateral meniscus is a relatively uncommon condition explained by an excessive mobility of the posterior horn of the lateral meniscus leading to knee pain and/or locking symptoms mostly with kneeling or squatting. This hypermobility is attributed to either congenital absence o injury of the posterior capsulo-meniscal attachment. These patients have a positive anamnesis and un inconstant physical exam with a normal MRI.
Between 2010 and 2019, 74 knees with hypermobile lateral meniscus were treated surgically without any other associated pathology. The diagnosis was confirmed at the time of the arthroscopy as the excessive translation of the posterior horn of the lateral meniscus to the center of the lateral plateau with fluid aspiration (Tom test) or with probe, without meniscus tear. Then, all-inside meniscal fixation was performed (routinely with two stitches). From the total series of patients, 57 were federated football players. 45 of those were reached for a retrospective (over the phone) evaluation: IKDC score, VAS score, Tegner score, complications and reoperations.
The mean follow-up was 43 months (8-73). The pre- and post-operative median Tegner score was 9 (6-9) and 8 (0-9) retrospectively. Return to play was possible in 38/46 (82%) cases, from which 27/46 (59%) corresponded to the same pre-injury level. Postoperatively, the median VAS for pain was 1 (0-9), and the mean subjective IKDC was 86.2. Three of the 46 cases (6.5%) required a reoperation because of pain in one patient (meniscal suture failure) and a meniscal tear in two patients.
The arthroscopic all-inside meniscal fixation is a successful treatment for hypermobile lateral meniscus which allows acceptable return to play and good function in football players at a low reoperation rate. However, the players should be advised that the return to the same pre-injury activity level is achieved in only 59% of the cases.