POPLITEOMENISCAL FASCICULI AND THE UNSTABLE LATERAL MENISCUS - CLINICAL CORRELATION AND MAGNETIC-RESONANCE DIAGNOSIS

We hypothesize that disruption of the fascicular attachments between t he popliteus and lateral meniscus can result in gross instability of t he meniscus producing locking of the knee. This study brings attention to the importance of the clinical examination, and the need for clini cal correlation to magnetic resonance (MR) studies, We report on three patients referred with the history of mechanical locking episodes of their knee, initial MR examinations were all read as normal before ref erral to our institution, On close review of these MR examinations, po pliteomeniscal fascicular disruption could be seen in each case. Each of these patients had arthroscopic repair of these meniscal detachment s. At I-year followup, all patients had resolution of mechanical sympt oms. Each patient had confirmation of their repair with repeat arthros copy or MR and arthrographic examinations, An anatomic specimen was us ed to identify the popliteus muscle and tendon, the lateral meniscus, the antero-inferior popliteomeniscal fascicle, and the postero-superio r popliteomeniscal fascicle attachments. MR images of the same anatomi c specimen show both superior and inferior fasciculus attachments to t he capsule, MR examples of the intact and disrupted antero-inferior an d postero-superior popliteomeniscal fasciculi have been correlated to anatomic specimens to help familiarize the orthopaedic surgeon with th ese important stabilizing structures.