scholarly journals Meniscal Root Tear: A Missed Epidemic?

2019 ◽  
Vol 7 (11_suppl6) ◽  
pp. 2325967119S0046
Author(s):  
Nadia Nastassia Ifran
Keyword(s):  
Physical Examination ◽  
Shock Absorber ◽  
Lateral Meniscus ◽  
Meniscal Tears ◽  
Root Tear ◽  
Injury Patterns ◽  
Radiological Findings ◽  
Meniscal Root ◽  
Meniscus Tears ◽  
Meniscal Root Tear

Meniscal root tears often go unnoticed and represent unique injury patterns with unique biomechanical consequences. Meniscal root tear occurs about 10-21% of all meniscal tears. Almost 10% of ACL tears involving posterior lateral meniscus tears. Meniscal root tears interrupt the continuity of the circumferential fibers, hence meniscus will fail to function as a shock absorber and load distributor. The biomechanical implication is the accelerated degeneration of the joint comparable to total meniscectomy. Repair of meniscal root tear will reduce contact pressure and increase contact area biomechanically similar to the uninjured meniscus. However, the repair must be done as anatomic as possible. Otherwise, the goal of restoring the meniscus function may not be achieved. Sign and symptoms, physical examination and radiological findings that may suggest a meniscal root tear will be discussed in this paper. Moreover, an overview of the management will also be described.

scholarly journals A Simple Way to Fix a Lateral Meniscal Root Tear

2021 ◽  
Vol 1 (4) ◽  
pp. 263502542110164
Author(s):  
Stefano Zaffagnini ◽  
Alberto Grassi ◽  
Giacomo Dal Fabbro
Keyword(s):  
Cruciate Ligament ◽  
Lateral Meniscus ◽  
Repair System ◽  
Root Tear ◽  
Concomitant Procedure ◽  
Meniscal Root ◽  
Kinematic Behavior ◽  
Meniscofemoral Ligaments ◽  
Meniscal Root Tear ◽  
Anterior Cruciate

Background: Meniscal posterior root tears, which are often associated with anterior cruciate ligament (ACL) injury, lead to the loss of normal biomechanical and kinematic behavior of menisci. Several arthroscopic techniques have been introduced to address this kind of injury. In this video, a simple all-inside technique to repair posterior lateral root tear (PLRT) is presented. Indications: To repair type 1, type 2, and type 4 PLRT. Technique: The torn lateral meniscus root is sutured to the medial fibers of the posterior cruciate ligament (PCL), with an arthroscopic all-inside repair system, with the purpose of reproducing the stabilizing function of the meniscofemoral ligaments. Results: This procedure allows restoration of the correct position of the detached horn, and restores meniscal stability with satisfactory clinical outcomes. Discussion/Conclusion: The technique described represents a simple and fast arthroscopic all-inside procedure to repair PLRT in association with concomitant procedure, such as ACL reconstruction. However, outcome reports of this technique are still lacking in the literature, and further studies are needed to confirm the authors’ results.

Should We Prefer Magnetic Resonance Imaging to Physical Examination in Meniscal Tears

2019 ◽  
Vol 33 (12) ◽  
pp. 1251-1255 ◽  
Author(s):  
Gökhun Arıcan ◽  
Ahmet Özmeriç ◽  
Özgür Şahin ◽  
Serkan İltar ◽  
Kadir Bahadır Alemdaroğlu
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Physical Examination ◽  
Lateral Meniscus ◽  
Meniscal Tears ◽  
Resonance Imaging ◽  
Predictive Values ◽  
Arthroscopic Findings ◽  
Meniscus Tears ◽  
Joint Line Tenderness

AbstractThe aim of this study was to compare the sensitivity, specificity, accuracy, positive and negative predictive values of magnetic resonance imaging (MRI), and clinical examination in the diagnosis of meniscus tears with the findings obtained from the knee joint arthroscopy. A retrospective study was made of 452 patients who underwent knee arthroscopy due to meniscus tears between 2012 and 2017. Physical examination was performed using the Thessaly's, McMurray's, and Joint line tenderness tests (JLTT). On preoperative MRI, medial meniscal tears were observed in 292 patients, lateral meniscal tears in 96 patients, and medial and lateral meniscal tears in 64 patients. According to the arthroscopy results, 284 patients had medial meniscal tears, 108 patients had lateral meniscal tears, and 60 patients had medial and lateral meniscal tears. Sensitivity and specificity of the JLTT was determined as 93 and 86% respectively for medial meniscal tears and 94 and 89% for lateral meniscal tears. The McMurray's test was 60% sensitive, 68% specific for medial meniscal tears (MMT), and 73% sensitive and 68% specific for lateral meniscus tears (LMT). The Thessaly's test was 93% sensitive and 87% specific for medial meniscal tears; and 94% sensitive and 88% specific for LMT. Compared with the arthroscopic findings, MRI was observed to have sensitivity of 94% for MMT and 84% for LMT. For specificity, the values were 89% for MMT and 91% for LMT. Accuracy was 89% for MMT and 86% for LMT. In comparison with the arthroscopic findings, the triple test was determined to have sensitivity of 92% for MMT and 89% for LMT. The specificity was 88% for MMT and 91% for LMT. The results of this study showed that a combination of selected physical examination methods is as sensitive as MRI in the diagnosis of meniscus tears.

scholarly journals High incidence of subsequent re-operation following treatments for medial meniscus tears combined with anterior cruciate ligament reconstruction: second-look arthroscopic study

2019 ◽  
Vol 31 (1) ◽  
Author(s):  
Sang-Gyun Kim ◽  
Soo-Hyun Kim ◽  
Jung-Heum Baek ◽  
Jae-Gyoon Kim ◽  
Ki-Mo Jang ◽  
...  
Keyword(s):  
Healing Rate ◽  
Medial Meniscus ◽  
Cruciate Ligament ◽  
Lateral Meniscus ◽  
Meniscal Tears ◽  
Acl Injuries ◽  
Second Look ◽  
Meniscus Tears ◽  
Anterior Cruciate

Abstract Background The Multicenter Orthopaedic Outcomes Network (MOON) group recently reported that medial meniscus (MM) repairs are associated with more frequent re-operations when compared to lateral meniscus (LM) repairs. The purpose of this study was to compare the meniscal healing and the incidence of subsequent re-operation of medial and lateral meniscal tears that occurred concurrently with anterior cruciate ligament (ACL) injuries. Methods We retrospectively reviewed patients who underwent second-look arthroscopy after primary ACL reconstruction (ACLR) between June 2005 to December 2016. The healing of meniscal tears following repair or left in situ, and re-tear following partial meniscectomy, were evaluated via second-look arthroscopy and compared between medial and lateral meniscus. Moreover, the incidence of subsequent meniscal re-operation after the index ACLR were investigated and compared between medial and lateral meniscus. Subsequent meniscal re-operation was performed in cases of the following three symptomatic meniscus tears: re-tears at the meniscectomy site; new tears; and failed healing of repaired or left in situ meniscus. Results There were 148 meniscal tears in 121 patients at index ACLR. There were 62 MM tears, 38 LM tears, and 24 bilateral meniscus tears. At second-look arthroscopy, the “successful healing” rate for tears following repair was higher in LM tears (91.2%) compared to MM tears (80.0%), although it was not statistically significant (p > 0.05). No significant differences were observed in the healing of left in situ tears or re-tear of meniscectomy site between medial and lateral meniscus. Patients with MM tears combined with ACL injuries had a higher incidence of subsequent meniscal re-operation compared to patients with LM tears (25.6% vs 16.1%, p = 0.025). Conclusions There was a trend for the successful healing rate to be higher in LM repairs than MM repairs. Subsequent meniscal re-operations after ACLR were more frequent in patients with medial meniscal tears concurrently with ACL injuries in comparison to patients with lateral meniscal tears. Level of study Level IV, retrospective case series.

scholarly journals Correlation of meniscus tears on MRI and arthroscopy using the ISAKOS classification provides satisfactory intermethod and inter-rater reliability

2020 ◽  
Vol 5 (4) ◽  
pp. 201-207
Author(s):  
Jay Shah ◽  
Rocco Hlis ◽  
Oganes Ashikyan ◽  
Anthony Cai ◽  
Kyle Planchard ◽  
...  
Keyword(s):  
Sports Medicine ◽  
Intraclass Correlation ◽  
Lateral Meniscus ◽  
Meniscal Tears ◽  
Tissue Quality ◽  
Level Of Evidence ◽  
Meniscus Tears ◽  
3.0 T ◽  
3.0 T Mri

ObjectiveTo evaluate the inter-rater and intermethod correlation (reliability between MRI and arthroscopy) of knee for findings of meniscus tears using International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) classification on both 1.5 and 3.0 T images.Methods81 knees were evaluated in 69 patients aged 30.0±12.6 years (mean±SD). Consecutive arthroscopy-proven meniscal tears were evaluated by two board-certified radiologists on MRI and two sports surgeons on arthroscopies. The surgically validated ISAKOS classification of meniscal tears was used to describe medial meniscus (MM) and lateral meniscus (LM) tears on MRI and re-evaluation of images from completed arthroscopies. Prevalence-adjusted bias-adjusted kappa (PABAK), t-tests and intraclass correlation coefficient (ICC) were calculated.ResultsFor LM on 1.5 T, the agreements for location, depth, tear length and pattern were good to excellent in all categories except fair for tissue quality (PABAK=0.35–0.41) and zone 2 (PABAK=0.35) identification. For MM, the agreements were good to excellent in all except moderate for tissue quality (PABAK=0.6) and zone 1 and 3 (PABAK=0.40–0.47), and fair for zone 2 identification (PABAK=0.27). Similar results were seen on 3 T with improved LM zonal identification (PABAK=0.52–0.90) and better correlation of tear lengths, which were different on 1.5 T vs 3.0 T (p=0.01–0.03). For 1.5 T cases, both MM and LM tear lengths were larger on MRI versus arthroscopy (MM, p=0.004; LM, p=0.095). For 3 T, the MM tear lengths were larger on MRI versus arthroscopy (p=0.001).ConclusionISAKOS classification of meniscal tears on both 1.5 and 3.0 T MRI provides satisfactory inter-rater and intermethod reliability for use in clinical practice. Level of evidence: IV.

scholarly journals Repair of the Posterior Lateral Meniscal Root Tear: Suture Anchor Fixation Through the Outside-In Anterior Cruciate Ligament Reconstruction Femoral Tunnel

2021 ◽  
Vol 10 (1) ◽  
pp. e151-e158
Author(s):  
Manuel Leyes ◽  
Cesar Flores-Lozano ◽  
Ignacio de Rus ◽  
María González Salvador ◽  
Eulogio Martin Buenadicha ◽  
...  
Keyword(s):  
Ligament Reconstruction ◽  
Suture Anchor ◽  
Femoral Tunnel ◽  
Cruciate Ligament ◽  
Root Tear ◽  
Meniscal Root ◽  
Meniscal Root Tear ◽  
Anterior Cruciate ◽  
Suture Anchor Fixation ◽  
Anchor Fixation

scholarly journals Lateral meniscal posterior root tears experience acceptable healing status after transtibial repair technique

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Cathrine Aga ◽  
Ingerid Baksaas Aasen ◽  
Carsten Brocker ◽  
Nina Jullum Kise ◽  
Stig Heir
Keyword(s):  
Lateral Meniscus ◽  
Case Series ◽  
Rate Of Change ◽  
Posterior Root ◽  
Root Tear ◽  
Meniscal Extrusion ◽  
Posterior Root Tear ◽  
Meniscal Root ◽  
Global Rate

Abstract Purpose To evaluate patient MRI results, demography and clinical outcome following transtibial repair of lateral and medial meniscal posterior root tears. Methods Patients treated with transtibial repairs of posterior meniscal root tears from 2015 through 2018 performed pre- and postoperative MRI scans. Outcome measures were continuity/discontinuity of the meniscal root and change in meniscal extrusion on MRI. Other outcomes were KOOS, Lysholm score, Tegner activity scale and the Global Rate of Change (GRoC) score for function and pain at follow-up. Study design Retrospective case-series. Results Of 41 patients, 36 attended follow-up at mean 26 (12–38) months postoperatively. At follow-up, 11 out of 18 lateral meniscus posterior root tear (LMPRT) versus 5 out of 18 medial meniscus posterior root tear (MMPRT) repairs were classified as healed. Meniscal extrusion decreased in LMPRTs from of 2.3 ± 1.5 mm to 1.4 ± 1.09 mm (p = 0.080) and increased in MMPRTs from 3.1 ± 1.6 mm to 4.8 ± 1.9 mm (p = 0.005) at FU (between-group difference, p < 0.001). LMPRT repairs were associated with ACL injury and additional meniscal injury and were younger and with lower BMI. No between-group differences were found for KOOS, Lysholm or GRoC Function scores. Tegner scale was higher and GRoC Pain score lower in the LMPRT group compared to the MMPRTs. Conclusion Following transtibial repair for meniscal posterior root repairs, the LMPRTs had a higher frequency of healing, whereas most MMPRTs continued to extrude, despite surgical intervention. The study confirmed that LMPRTs and MMPRTs differ in demography and associated injuries.

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