The meniscal roots are essential for preserving the native biomechanical and structural properties of the tibiofemoral joint. Meniscus root avulsions, which disrupt the normal meniscus anchoring points, have been reported to result in deleterious biomechanics and clinical outcomes. In this series, two cases of iatrogenic medial meniscus anterior root avulsions after anterior cruciate ligament (ACL) reconstruction are reported. Iatrogenic medial meniscus anterior root avulsions after malpositioning of the tibial tunnels during ACL reconstruction have not been previously reported in the literature and may account for poor long-term outcomes seen in some patients after ACL reconstruction. Therefore, careful attention must be paid to correct tibial tunnel placement during ACL reconstruction.
Level of evidence: Case series, Level IV.