Arthroscopic Diagnosis and Treatment of a Hidden Intrameniscal Fracture of the Medial Meniscus

Our understanding and ability to identify meniscal tears has dramatically increased over the past decade. Many studies have, for example, focused their attention in describing the hidden meniscocapsular and meniscotibial lesions of the posterior horn of the medial meniscus. They highlighted that a significant amount of meniscal tears could still be easily overlooked depending on their location and complexity. These “hidden lesions” are difficult to diagnose with standard preoperative imaging, so arthroscopic probing remains the gold standard. Apart from these particular lesions, in-depth probing of the rest of the the meniscus may have been underestimated, especially in the presence of an unaltered external surface of the meniscus during visual arthroscopic inspection. In this Technical Note, the arthroscopic diagnostic procedure and repair technique of a hidden meniscal injury, identified as an “intrameniscal fracture,” is described.