The Direct Medial and Lateral Inferior Horizontal Portals of the Knee: A Modified Arthroscopic Approach for Anterior Horn Horizontal Tears

Mild horizontal tears in the meniscal avascular zone are common intraoperative findings during complex meniscal or discoid meniscus surgeries. However, resecting the inferior surface of such tears in the anterior one-half to one-third of the meniscal body is difficult and time-consuming because of arthroscopic visualization and instrument limitations. Herein, we describe a direct medial and lateral inferior portal inferior to the anterior one-third of the meniscal body, which enables efficient debridement of deep horizontal tears with shavers or rongeurs and enhances arthroscopic observation, thus improving surgical efficiency and reducing procedural difficulty.