TY - JOUR
T1 - The aspiration test
T2 - an arthroscopic sign of lateral meniscus posterior horn instability
AU - Jacquet, Christophe
AU - Magosch, Amanda
AU - Mouton, Caroline
AU - Seil, Romain
N1 - Publisher Copyright:
© 2021, The Author(s).
PY - 2021/2/28
Y1 - 2021/2/28
N2 - The suspensory mechanism of the posterior horn of the lateral meniscus (PHLM) is an anatomically complex structure including the popliteomeniscal fascicles, the meniscotibial posterior root attachment and the meniscofemoral ligaments. Damage to one or several of these structures – either through knee trauma or congenital abnormalities—can result in an instability of the PHLM that may lead to lateral knee pain, locking sensations or lack of rotational control of the knee (e.g. after anterior cruciate ligament injuries). The diagnosis of PHLM instability is complex due to the lack of reliable clinical tests and imaging signs. Direct visual dynamic inspection via arthroscopy thus remains the gold standard. However, arthroscopic probing of the PHLM is not always reliable and the precise quantification of the amount of subluxation of the PHLM can be difficult. Therefore, the main objective of this report was to describe a quick and easy arthroscopic screening test called “the aspiration test” in order to help surgeons to detect PHLM instability. During the exploration of the lateral tibiofemoral compartment with the knee kept in the figure of 4 position, the arthroscope is placed in the antero-lateral portal and directed towards the lateral tibiofemoral compartment. The aspiration test is then performed by activating the aspiration of the 4-mm shaver when located in the intercondylar notch. In case of a PHLM instability, an excessive displacement of the PHLM is observed. After repair, a second aspiration test allows to verify that the PHLM has been stabilized.
AB - The suspensory mechanism of the posterior horn of the lateral meniscus (PHLM) is an anatomically complex structure including the popliteomeniscal fascicles, the meniscotibial posterior root attachment and the meniscofemoral ligaments. Damage to one or several of these structures – either through knee trauma or congenital abnormalities—can result in an instability of the PHLM that may lead to lateral knee pain, locking sensations or lack of rotational control of the knee (e.g. after anterior cruciate ligament injuries). The diagnosis of PHLM instability is complex due to the lack of reliable clinical tests and imaging signs. Direct visual dynamic inspection via arthroscopy thus remains the gold standard. However, arthroscopic probing of the PHLM is not always reliable and the precise quantification of the amount of subluxation of the PHLM can be difficult. Therefore, the main objective of this report was to describe a quick and easy arthroscopic screening test called “the aspiration test” in order to help surgeons to detect PHLM instability. During the exploration of the lateral tibiofemoral compartment with the knee kept in the figure of 4 position, the arthroscope is placed in the antero-lateral portal and directed towards the lateral tibiofemoral compartment. The aspiration test is then performed by activating the aspiration of the 4-mm shaver when located in the intercondylar notch. In case of a PHLM instability, an excessive displacement of the PHLM is observed. After repair, a second aspiration test allows to verify that the PHLM has been stabilized.
KW - Aspiration test
KW - Hypermobile lateral meniscus
KW - Popliteo-meniscal complex
KW - Popliteo-meniscal fascicles
KW - Posterior horn lateral meniscus instability
UR - http://www.scopus.com/inward/record.url?scp=85102042736&partnerID=8YFLogxK
UR - https://www.ncbi.nlm.nih.gov/pubmed/33646453
U2 - 10.1186/s40634-021-00327-0
DO - 10.1186/s40634-021-00327-0
M3 - Article
C2 - 33646453
AN - SCOPUS:85102042736
SN - 2197-1153
VL - 8
SP - 17
JO - Journal of Experimental Orthopaedics
JF - Journal of Experimental Orthopaedics
IS - 1
M1 - 17
ER -