Incidence
Up to 8% reported in ACL reconstructions
Natural History
Very poor
- leads to mensical extrusion
- increased tibio-femoral contact pressure
- rapid early OA
- equivalent to total meniscectomy
MRI
Findings
- meniscal extrusion
- meniscal ghost sign on sagittal (missing meniscus)
Arthroscopy
Have to look either posteromedial or posterolateral to identify
Surgical Management
1. Suture anchor repair
- posterior compartment cannula
- insert cannula into posterior tibial plateau
- pass sutures and tie
2. Transtibial pullout repair
Technique
- use ACL guide
- pass under ACL / PCL to get to root insertion
- camera through posterolateral / posteromedial portal
- pass beath pin under vision
- pass endobutton drill under vision
- debride insertion
- pass sutures through meniscal root (either labral suture passer or rotator cuff suture passer)
- retrieve through tunnel with houston suture passer
- tie over endobutton
