Meniscus tear associated with the cruciate ligament injury.

Meniscal tears can happen frequently in car accidents.

It is often a peripheral vertical fissure in the red and vascularized area. It is likely to heal. The diagnosis of a meniscus lesion is difficult because the sprain and the pain make the examination difficult.

MRI or arthroscopy will help to make a more objective diagnosis. The initial treatment of an ACL tear allows the lesion to heal. A few weeks later, the treatment becomes that of an anterior cruciate ligament tear in the context of what we call chronic anterior laxity.

Rarely, the knee may develop a bucket handle. The knee is blocked and extension is impossible. In order to remove the blockage and preserve the medial meniscus, early concomitant reconstruction of the ACL and meniscal lesion is performed.

It can also happen some time after the initial accident.

A few weeks after the ACL injury, you are back to normal life. But a few months later, while a rotation, twisting or jumping, you have another instability accident. This episode is due to the persistent dysfunction in your knee, which is the source of the instability. This new injury is called a secondary traumatic joint lesion and can involve the posterior wedge of the medial meniscus (root), the peripheral part (ramp lesion), or even the body of the medial meniscus.

This meniscus tear marks a turning point in the patient’s history and clinical tolerance. It often leads to surgery. If the patient is young and athletic, ACL reconstruction and meniscal repair may be considered in the same operation. Again, the younger the patient and the more peripheral the injury, the more justified a meniscus reconstruction may be. Sometimes it is no longer possible to preserve the meniscus and the surgeon decides to perform a meniscectomy in the most cost-effective way possible.

Meniscus repair without ACL reconstruction, which is like performing an isolated meniscus repair on an unstable knee, is doomed to failure. It is unlikely that your surgeon will suggest this option.