scholarly journals Potential of the non-weight-bearing tunnel view in diagnosing medial meniscus posterior root tear: a pilot study of X-ray characteristics

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Hiroki Okamura ◽  
Hiroki Ishikawa ◽  
Takuya Ohno ◽  
Shogo Fujita ◽  
Shigeo Yamakami ◽  
...  
Keyword(s):  
Pilot Study ◽  
Medial Meniscus ◽  
Femoral Condyle ◽  
Weight Bearing ◽  
Disease Diagnosis ◽  
Posterior Root ◽  
Root Tear ◽  
X Ray ◽  
Posterior Root Tear ◽  
Significant Difference

Abstract Purpose Early detection of medial meniscus posterior root tear (MMPRT) is important in preventing the rapid onset and progression of degenerative knee disease. Diagnosis is facilitated by the availability of non-weight-bearing X-ray view, but information on the X-ray characteristics of MMPRT is scarce. Here, we conducted a pilot study of the X-ray characteristics of MMPRT on non-weight-bearing tunnel view. Methods We retrospectively reviewed 43 consecutive patients treated in the outpatient department for medial knee pain or popliteal pain. Patients were divided into MMPRT (21 knees) and non-MMPRT groups (22 knees). We investigated X-ray characteristics and magnetic resonance imaging findings. Femorotibial angle, posterior tibial slope, medial tibial eminence (MTE)–medial femoral condyle (MFC) distance (contralateral and affected sides, and difference between the two), medial tibiofemoral joint (MTFJ) width (contralateral and affected sides, and difference between the two), and meniscus radial dislocation between the groups were evaluated using the Mann–Whitney U test. The association between X-ray characteristics and MMPRT was determined using univariate and multivariate logistic regression analyses. Results A highly significant difference between the affected and contralateral sides was seen in MTFJ width and MTE–MFC distance on non-weight-bearing tunnel view between the MMPRT and non-MMPRT groups. Moreover, a difference in MTFJ width of <−0.575 mm and in MTE–MFC distance of >0.665 mm between the affected and contralateral sides was useful in predicting MMPRT. Conclusions The non-weight-bearing tunnel view is useful for the initial diagnosis of MMPRT. Prospective evaluation in a larger population is warranted.

scholarly journals Comparison of medial and lateral tibial tunnel in pullout repair of posterior root tear of medial meniscus: Radiologic, clinical, and arthroscopic outcomes

2020 ◽  
Vol 28 (2) ◽  
pp. 230949902091875
Author(s):  
Sai-Won Kwon ◽  
Jun Bum Kim ◽  
Chang Hyun Kim ◽  
Si John Hong ◽  
Yong Cheol Hong ◽  
...  
Keyword(s):  
Medial Meniscus ◽  
Tibial Tunnel ◽  
Suture Technique ◽  
Posterior Root ◽  
Root Tear ◽  
Posterior Root Tear ◽  
Lateral Tunnel ◽  
Significant Difference ◽  
Tunnel Technique ◽  
The Mean

Purpose: Medial meniscus posterior root tear (MMPRT) should be repaired to the correct position as possible to maintain hoop tension of the meniscus. In this study, we propose a comparison of the outcome between the medial tunnel and the lateral tunnel in the pullout suture technique using the tibial tunnel for anatomical repair of posterior root tear of medial meniscus. Methods: From April 2010, of patients who underwent pullout suture, 51 cases (24 medial tunnel group (MTG) and 27 lateral tunnel group (LTG)) were able to follow-up with second look arthroscopy. Original Coronal Ratio of Root Attachment (CRORA) was defined as the ratio of the distance from the medial edge of the tibial plateau to the root attach site divided by the entire tibial medial–lateral width on preoperative computed tomography. Error between postoperative CRORA and original CRORA was calculated. We compared this error, clinical outcome, and arthroscopic finding between MTG and LTG. Results: The mean error ratio of postoperative CRORA divided by original CRORA was 0.86 ± 0.11 in MTG, which was significantly ( p = 0.001) lower than that (1.02 ± 0.06) in LTG. The mean value of the root attach point in the MTG with a post/original CRORA value of 0.86 ± 0.11 means statistically significant medialization after the operation. There was no statistically significant difference in changes of International Knee Documentation Committee (IKDC) and Lysholom score between MTG and LTG. The difference between the two groups of arthritis progression was not statistically significant. Conclusion: In patients with MMPRT, CRORA may provide a basis for coronal assessment of root repair position before and after surgery, and lateral tibial tunnel technique can help anatomical repair by reducing technical error due to guide pin slip medially compared to medial tibial tunnel technique.

scholarly journals Correlation between meniscal extrusion and symptom duration, alignment, and arthritic changes in medial meniscus posterior root tear: research article

2020 ◽  
Vol 32 (1) ◽  
Author(s):  
Dong Hwi Kim ◽  
Gwang Chul Lee ◽  
Hyun Hak Kim ◽  
Dong Hyuk Cha
Keyword(s):  
Medial Meniscus ◽  
Posterior Root ◽  
Root Tear ◽  
X Ray ◽  
Posterior Root Tear ◽  
Grade Ii ◽  
The Mean ◽  
Medial Meniscus Extrusion ◽  
Meniscus Extrusion ◽  
Grade Iii

Abstract Background Medial meniscus posterior root tear can result in medial meniscus extrusion. However, the severity of medial meniscus extrusion is different in each root tear patient. The purpose of this study was to identify the factors that contribute to the severity of medial meniscus extrusion with medial meniscus posterior root tear, such as duration of disease, the degree of arthritis—chondral wear, subchondral edema, osteophyte size, and Kellgren–Lawrence (K/L) grade—and mechanical alignment for appropriate treatment method. Methods From January 2009 to August 2014, we retrospectively analyzed magnetic resonance imaging (MRI) and simple x-ray of 99 patients with medial meniscus posterior root tear. The duration of the disease was identified through retrospective chart review. The severity of medial meniscus extrusion, the presence of subchondral edema, the degree of chondral wear, and the size of the osteophyte were measured on MRI. K/L grade was confirmed on simple x-ray, and the mechanical axis was measured on whole extremity radiographs. Statistical analysis was performed by using bivariate correlation analysis and one-way analysis of variance. Results The mean medial meniscus extrusion was 4.61 mm, and the mean duration of the disease was 15.52 months. The mean degree of chondral wear was 25.8%, and 63 out of 99 cases showed subchondral edema. The average alignment was 4.30 degrees, and the average size of the osteophyte was 1.48 mm. There were 40 cases (40.4%) with K/L grade I, 48 cases (48.5%) with grade II, 11 cases (11.1%) with grade III, and no cases with grade IV. In the group mean analysis between the K/L grade and the severity of medial meniscus extrusion, the average medial meniscus extrusions were 3.97 mm in grade I, 4.93 mm in grade II, and 5.59 mm in grade III. There was a statistical significance between the size of the osteophyte and the severity of medial meniscus extrusion (P = 0.000), K/L grade, and the severity of medial meniscus extrusion (P = 0.001). Conclusions The severity of medial meniscus extrusion with medial meniscus posterior horn root tear is associated with the size of the osteophyte and K/L grade.

scholarly journals A Retrospective Review of Unicompartmental Knee Arthroplasty Functional Outcome and the Incidence of Medial Meniscus Posterior Root Tear in Spontaneous Osteonecrosis of the Knee

2020 ◽  
Author(s):  
PO-JU WU ◽  
TsungYu Lin ◽  
Yung Chang Lu
Keyword(s):  
Effective Treatment ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Medial Meniscus ◽  
Functional Improvement ◽  
Posterior Root ◽  
Root Tear ◽  
Posterior Root Tear ◽  
Unicompartmental Knee ◽  
Spontaneous Osteonecrosis

Abstract Background:Spontaneous osteonecrosis of the knee (SONK) can lead to severe knee osteoarthritis predominantly localized to the medial compartment. We aimed to determine whether unicompartmental knee arthroplasty was an effective treatment for primary SONK.Methods:We analyzed the functional outcomes in 23 patients with SONK (with a magnetic resonance imaging [MRI]-confirmed diagnosis) who underwent UKA at a single center. The mean follow-up time was 67 months post-UKA.Results:Significant improvements in function were indicated by reduced Oxford Knee and Visual Analogue Scale scores after UKA, and there were no specific complications after the procedures. The incidence of MRI-identified medial meniscus posterior root tear (MMPRT) was 69.6% (16/23).Conclusion:Unicompartmental arthroplasty for SONK is less destructive to the native knee structure than total knee arthroplasty, but can achieve comparable prognosis with strict patient selection. While the precise etiology of SONK is unknown, one theory posits that a MMPRT may change the biomechanical circumstances of the knee joint, leading to osteonecrosis. Although not confirmatory, the high prevalence rate suggests that MMPRT may have a key role in the development of SONK. UKA is an effective treatment option for SONK, resulting in significant functional improvement. Long-term (>10 years) outcomes should be investigated.

scholarly journals Risk Factors for Medial Meniscus Posterior Root Tear

2012 ◽  
Vol 40 (7) ◽  
pp. 1606-1610 ◽  
Author(s):  
Byoung-Yoon Hwang ◽  
Sung-Jae Kim ◽  
Sang-Won Lee ◽  
Ha-Eun Lee ◽  
Choon-Key Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Medial Meniscus ◽  
Posterior Root ◽  
Root Tear ◽  
Posterior Root Tear
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