Arthroscopic Repair of Posterior Root Tear of the Lateral Meniscus Using the Anterior Meniscofemoral Ligament

Abstract Posterolateral meniscus root tears are frequently associated with anterior cruciate ligament injuries and contribute to altered knee biomechanics, increased joint loading, and potential graft failure. Despite various described repair techniques, the use of the anterior meniscofemoral ligament (aMFL, ligament of Humphrey) for repair is not widely popular, a structure that remains intact in most posterolateral meniscus root tears cases and shows strong anatomical and biomechanical integration with the posterior horn of the lateral meniscus. This article describes an arthroscopic technique utilizing the aMFL for the anatomical reconstruction and stabilization of lateral meniscus posterior root tears. This method aims to improve fixation strength and biological healing by leveraging an existing ligament with a favorable insertion trajectory and structural continuity with the meniscal root. The aMFL is arthroscopically dissected, sutured at its femoral attachment and then detached above the suture. A tibial tunnel is placed in the area of the remnants of the posterior root; then, the aMFL is shuttled through the tunnel and fixated within it using an interference screw or in the hybrid form with extracortical fixation.