Efficacy of Arthroscopic Treatment for Concurrent Medial Meniscus Posterior Horn and Lateral Meniscus Anterior Horn Injury: A Retrospective Single Center Study

Annotation. Among the large joints, the knee joint is most often injured, which is due to the peculiarities of its structure and functional loads in the process of human life. The most common injuries are meniscus damages of the knee joint, that is the evidence of steady increase in the number of partial arthroscopic meniscectomies, which have become the most common orthopedic procedure. Diagnosis of meniscus damage is based on the results of clinical examination, sonography and MRI. Increasing the resolution of MRI machines, improving the technique of their implementation allows to improve the quality of diagnosis of meniscus ruptures and improve the results of surgical arthroscopic interventions on the knee joint. The aim of the study – to demonstrate the capabilities of high-intensity 1.5 Tesla MRI and to study the reliability of MRI signs of meniscus damage in comparison with the results of arthroscopic interventions in acute and chronic knee joint injury. The work is based on the results of MRI examinations and arthroscopic interventions of 247 patients with acute and chronic knee joint injuries aged 14 to 59 years. Medial meniscus damage was diagnosed in 206 (83.41%) patients. Lateral meniscus ruptures were diagnosed in 34 patients (13.76%). Simultaneous damage of both menisci was found in 7 (2.83%) patients. It was found that ruptures of the medial meniscus by location were: the root of the posterior horn of the medial meniscus in 4 (1.94%) patients, ruptures of the posterior horn in 82 (39.81%) patients. Injury of the posterior horn with the transition to the body of the meniscus was diagnosed in 117 (56.79%) patients. Anterior horn ruptures were detected in 3 (1.46%) patients. With ruptures of the lateral meniscus: damage of the root of the posterior horn of the lateral meniscus was found in 2 (5.88%) patients, damage of the posterior horn in 9 (26.47%) patients. Posterior horn rupture with transition to the body of the meniscus was diagnosed in 19 (55.89%) patients. Isolated ruptures of the anterior horn were found in 4 (11.76%) patients. Simultaneous damage to both menisci was found in 7 (2.83%) patients. 206 (83.40%) partial meniscectomies were performed during arthroscopic interventions and meniscus suturings were performed over 41 (16.60%) patients. In order to identify meniscus damage and their location during MRI knee joint investigations 21 pseudo-positive and 18 pseudo-negative cases of diagnosis were revealed. The sensitivity of MRI for defining damage and localization of meniscus rupture was 91,7%, specificity 92,6%, diagnostic accuracy 94,8%. Discrepancies in the evaluation of meniscal damage most often occurred in cases of their combined ruptures and degenerative changes in the menisci.

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The prevalence and characteristics of a subcortical cystic lesion at the subspinous region of the knee

Acta Radiologica ◽

10.1177/0284185117703153 ◽

2017 ◽

Vol 59 (1) ◽

pp. 97-104 ◽

Cited By ~ 1

Author(s):

Ji Ye Son ◽

Young Cheol Yoon ◽

Wook Jin ◽

Jang Gyu Cha

Keyword(s):

Bone Marrow ◽

Medial Meniscus ◽

Cruciate Ligament ◽

Lateral Meniscus ◽

Cyst Formation ◽

Posterior Horn ◽

Anterior Horn ◽

Cruciate Ligaments ◽

Magnetic Resonance Imaging Mri ◽

Subcortical Cysts

Background Although we observed that subcortical cysts near the attachment of the meniscus or cruciate ligaments are frequently seen with a tear or degeneration of the adjacent meniscus and/or cruciate ligament, there is no large study describing the prevalence, distribution, and associated findings of these cysts. Purpose To evaluate the prevalence and distribution of subcortical cysts near the attachments of the meniscus or cruciate ligaments and evaluate pathologies of the meniscus or cruciate ligaments using magnetic resonance imaging (MRI). Material and Methods We reviewed 1009 knee MRIs for the presence of subcortical cysts near the meniscus or cruciate ligament attachments and evaluated their size, location, edema of the adjacent bone marrow, and integrities of the medial and lateral meniscus and anterior and posterior cruciate ligaments. Results The 110 cysts were found in either the middle (n = 56), posterior (n = 52), or anterior (n = 2) subspinous regions. Sixty-two were at meniscal root insertion, including seven at the lateral meniscus anterior horn, five at the lateral meniscus posterior horn, 48 at the medial meniscus posterior horn, and two at the medial meniscus anterior horn. All were associated with an adjacent meniscal pathology. Of the 34 cysts at the anterior cruciate ligament (ACL) insertion, 28 had ACL pathology. Nine cysts had surrounding edema in the adjacent bone marrow. Conclusion Subcortical cysts at the subspinous region of the knee were seen in 9.6% of knee MRI examinations. Most were in close proximity to the meniscal or cruciate ligaments with associated pathologies, suggesting that abnormal stress on the bone induces cyst formation.

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