“Zip” Lesion of the Lateral Meniscus Repair Technique Using All-Inside Meniscus Repair Device

Ramp lesion of the medial meniscus is an established clinical entity and is one of the causes of the positive pivot-shift test with anterior cruciate ligament (ACL) injury. A similar lesion in the region of the posterior horn of the lateral meniscus extending to the posterior meniscocapsular junction posterior to the popliteal hiatus along with ACL injury is called a “zip lesion.” These patients do exhibit a positive pivot shift under anesthesia. We have encountered different injury patterns to the lateral meniscocapsular junction, which can cause altered knee kinematics, and they should be looked for while performing an ACL reconstruction. Failure to identify and repair these lesions will have a deleterious effect on the knee kinematics. If untreated, these lesions may lead to compromised results of the ACL reconstruction. This Technical Note proposes a repair technique for the zip lesion.