"Aggressive" nontreatment of lateral meniscal tears seen during anterior cruciate ligament reconstruction.

Based on our experience, we hypothesized that certain lateral meniscal tears identified at the time of anterior cruciate ligament reconstruction can be left without removal or repair and that they will remain asymptomatic. We looked at 189 lateral meniscal tears that were left in situ at the time of anterior cruciate ligament reconstruction. At an average clinical followup of 2.6 years (range, 1 to 9 years) we found that 1) posterior horn avulsion tears, if left alone, do not cause clinical symptoms after anterior cruciate ligament reconstruction; 2) vertical tears totally posterior to the popliteus tendon are asymptomatic before and after reconstruction; and 3) other complete and incomplete lateral meniscal tears (vertical longitudinal, radial, or anterior vertical), if stable at the time of anterior cruciate ligament reconstruction, can be left in situ without becoming clinically symptomatic. All patients in the study population returned to their desired level of sporting activities by the time of follow-up evaluation. Our high clinical success rate in leaving selected lateral meniscal tears in situ is an "aggressive" attempt at meniscal salvage without increased morbidity from repair or resection. During the time we observed the patients (1 to 9 years), the lateral menisci remained asymptomatic.