translation.
There is an obvious displaced bucket handle tear of the medial meniscus
with the bucket handle fragment centrally located in the notch under the
PCL.
There is obvious tear of the PHLM.
My questions are regarding the following:
1. There is a tear through the posterior horn medial meniscus root ligament
(red arrows) with absolutely no meniscus body extrusion (blue arrow) and no
degenerative cartilage loss at the medial compartment.
2. There is not much joint effusion, but there is fluid localized to this
outpouching at the posterolateral knee, in the region of the popliteal
hiatus. I can’t make out a tear of the posterolateral complex, but it’s
been 3 years and wonder if this appearance suggests previous tearing and
scar remodeling with chronic incompetence of the posterolateral complex
(white arrows).
Look:
[image: 1.jpg]
[image: 2.jpg]
[image: 3.jpg]
[image: 4.jpg]
[image: 5.jpg]
[image: 6.jpg]
I wonder what the surgical implications are.
Bucket handle tears can sometimes be repaired, though I don’t know if the
chronicity affects that.
But I don’t recall seeing a concomitant meniscal root tear.
It’s odd that there is neither meniscal body extrusion nor medial
compartment cartilage loss in the setting of a chronic meniscal root tear,
unless its somehow not unstable?
Because it would be pointless to repair the bucket handle tear without
repairing the root ligament…..do you agree, or no????
ALSO, I wonder if anything is going on with that posterolateral
complex…because I have understood that ACL reconstruction might fail if
the posterolateral complex is not repaired.
Curious what you all think.
OK…maybe not all….considering there are more than 1340 of us!
Hilary
