The popliteomeniscal fascicles are two fibrous bands, anteroinferior and posterosuperior, that connect the popliteus muscle and tendon to the posterior horn of the lateral meniscus. They form the posterior attachment of the lateral meniscus and define the superior and inferior borders of the popliteal hiatus through which the popliteus tendon passes. They are critical stabilisers of the posterior lateral meniscus that normally has no posterior capsular attachment.
Anchor the posterior horn of the lateral meniscus to the popliteus musculotendinous unit, preventing posterior horn instability during knee flexion, and enabling the popliteus to retract the posterior lateral meniscus during tibial internal rotation in the screw-home movement.
Popliteomeniscal fascicle tears produce excessive posterior lateral meniscal mobility, causing a snapping or subluxating lateral meniscus that can be reproduced on MRI by specific loading positions. This is a recognised cause of lateral compartment pain and clicking that does not respond to standard meniscal repair. Arthroscopic assessment distinguishes normal hiatus anatomy from abnormal fascicle tears. Repair of torn fascicles restores posterior meniscal stability when intact remnant tissue is present.
Tears of the anteroinferior or posterosuperior popliteomeniscal fascicles allow the posterior horn of the lateral meniscus to sublux into the joint, producing a palpable and reproducible lateral snap during knee flexion and extension, diagnosed by dynamic MRI or arthroscopy and treated by fascicle repair or posterior horn stabilisation.
