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Symptomatic Dislocation of the Anterior Horn of the Medial Meniscus: Case Report and Review

Heinz Lohrer

Am J Case Rep 2009; 10:78-83

ID: 869684

Background: Isolated symptomatic dislocations of the anterior horn of the medial meniscus are extremely rare. Review of the literature revealed 14 cases all suffering from anteromedial joint line pain. Effusion, locking, clicking, and giving way like phenomenons were not constantly found. Physical examination and results of imaging modalities were unspecific. Different surgical techniques were performed.
Case Report: A 20-years-old field hockey goalkeeper complained four injuries to his right knee during a seven years period. Clinical findings and imaging modalities were unspecific. Arthroscopic investigation revealed an avulsion and dislocation of the anterior medial meniscus horn. Repair resulted in full high level sports ability. Adding the presented patient, 15 cases suffering from isolated symptomatic dislocation of the anterior horn of the medial meniscus were considered for analyses. Included patients were 15–28 years old and were active in different sports. All knees presented anteromedial joint line pain. 20–40% of the knees suffered from effusion, locking, clicking, and giving way like phenomenons. Physical examination (point tenderness over anteromedial joint line =15/15) and imaging was unspecific. Results of different surgical procedures were judged as excellent in 5/15 and as good in 10/15.
Conclusions: The clinical representation of anteromedial meniscus horn avulsions is unspecific and is frequently overlooked by non invasive diagnostic methods. Patients who present with anteromedial knee pain, mild effusion and giving way or fear of giving way in spite of a stable knee must be regarded as candidates for this lesion.

Keywords: articular, Ligaments, Arthroscopy, menisci, Knee, Surgery

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