ARTHROSCOPIC MENISCAL REPAIR WITH FIBRIN CLOT OF COMPLETE RADIAL TEARS OF THE LATERAL MENISCUS IN THE AVASCULAR ZONE

Peripheral lateral meniscal tears are amenable to arthroscopic menisca l repair. However, the posterolateral aspect of the lateral meniscus a djacent to the popliteus tendon is devoid of penetrating peripheral ve ssels and therefore difficult to heal. A complete radial split at this site is usually treated with total meniscectomy. We report ve cases o f a tear of the posterolateral aspect of the lateral meniscus anterior to the popliteus fossa. All patients had a radial split that extended to the popliteus tendon. In all cases, the repair was enhanced with a fibrin clot. Second-look arthroscopy showed that healing of the perip hery occurred in all of the cases. All patients returned to their init ial level of sports activity, Three of five patients were available fo r follow-up at an average of 71 months, and magnetic resonance imaging was performed at that time to assess the previously repaired meniscus . All menisci were fully healed and showed no further signs of degener ation The ability of an exogenous fibrin clot to stimulate and support a reparative response in the avascular portion of the meniscus may re present a potential method of repair. Awareness of the relatively low healing potential of this zone and enhancement of healing opportunitie s should improve outcome.