Type 3 lesions, also known as “hidden lesions,” occur in the most inferior portion of the posterior horn and are associated with meniscotibial ligament instability.
They are not visible with the transnotch approach, but they may be suspected in case of mobility at probing.
There are two different subtypes of type 3 lesions in order to account for the meniscotibial ligament instability.
Type 3A represents a vertical peripheral tear of the inferior margin of the posterior horn containing the attachment of the meniscotibial ligament.
Though not torn, the meniscotibial ligament is no longer directly connected to the medial meniscus, and thus becomes unstable.
On MRI, this tear pattern manifests as a linear vertical oblique fluid intensity signal reaching the inferior articular surface, with intact the meniscotibial ligament.
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