Early Surgical Repair of Medial Meniscus Posterior Root Tear Minimizes the Progression of Meniscal Extrusion: Response

Moon, Hyun Soo; Choi, Christine; Jung, Min; Lee, Dae-Young; Hong, Seungpyo; Kim, Sunghwan

doi:10.1177/0363546520974380

Cited by 4 publications

(4 citation statements)

References 11 publications

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“…On the other hand, Moon et al. describe that three (4.8%) patients showed partial MMPRTs corresponding to LaPrade classification type 1 tears in arthroscopic image analyses of 63 patients [ 20 ]. They report that complete radial (type 2) and complex oblique (type 4) tears accounted for 88.9% and 6.3% of the MMPRTs, respectively [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…describe that three (4.8%) patients showed partial MMPRTs corresponding to LaPrade classification type 1 tears in arthroscopic image analyses of 63 patients [ 20 ]. They report that complete radial (type 2) and complex oblique (type 4) tears accounted for 88.9% and 6.3% of the MMPRTs, respectively [ 20 ]. Several authors demonstrate that the rate of type 1 partial MMPRTs accounts for 3.9% (5/128 knees) [ 21 ], 7.2% (6/83 knees) [ 22 ], and 16.4% (19/116 knees) [ 23 ] in patients with MMPRTs who underwent arthroscopic treatments.…”

Section: Discussionmentioning

confidence: 99%

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A characteristic MRI finding to diagnose a partial tear of the medial meniscus posterior root: an ocarina sign

Furumatsu

Hiranaka

Kintaka

et al. 2021

Knee Surg & Relat Res

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Background Diagnosing partial tears of the medial meniscus (MM) posterior root is difficult. The aim of this study was to evaluate diagnostic values involved in conventional magnetic resonance imaging (MRI) features of MM posterior root tears (MMPRTs) and find other MRI-based findings in patients with partial MMPRTs. Methods Eighteen patients who had arthroscopically confirmed partial MMPRTs were included. As a control, 18 patients who underwent partial meniscectomy for other types of MM tears were evaluated. Isolated partial MMPRTs were classified into the following three types: type A, accurate partial stable tear (cleavage < 1/2 of root width); type B, bridged unstable root tear (cleavage ≥ 1/2 of root width); type C, complex horn tear expanded to the root. Conventional MRI-based findings of MMPRTs were evaluated between two groups (n = 23). Posterior root irregularity, bone marrow spot, and ocarina-like appearance showing several condensed circles in triangular meniscal horn (ocarina sign) were also evaluated. Results Posterior root irregularity and bone marrow spot were frequently observed in the partial MMPRTs (47.8%), compared with the other MM tears (P = 0.007 and 0.023, respectively). The ocarina sign was detected in 69.6% of patients with partial MMPRTs. A significant difference between two groups was observed in a positive ratio of ocarina sign (P < 0.001). Types A, B, and C of the partial tear/damage were observed in three, eight, and seven patients, respectively. The ocarina sign was the most common MRI finding in each type of partial MMPRT. Conclusions This study demonstrated that a characteristic MRI finding, “ocarina sign,” was frequently observed in patients with partial tear/damage of the MM posterior root. The ocarina sign was the most common MRI finding in several types of partial MMPRTs. Our results suggest that the ocarina sign may be useful to diagnose unnoticed partial MMPRTs. Level of evidence: IV, retrospective comparative study.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A characteristic MRI finding to diagnose a partial tear of the medial meniscus posterior root: an ocarina sign

Furumatsu

Hiranaka

Kintaka

et al. 2021

Knee Surg & Relat Res

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“…Furthermore, this classification system provides potential criteria for predicting the chronicity of an MMRT. Types 1, 2, and 4 are associated with acute or chronic tears, whereas types 3 and 5 are usually found in acute traumatic tears [ 23 , 24 ]. Among the five types of MMRTs, type 2 is the most common [ 23 , 24 ].…”

Section: Medial Meniscus Posterior Root Tearmentioning

confidence: 99%

“…Types 1, 2, and 4 are associated with acute or chronic tears, whereas types 3 and 5 are usually found in acute traumatic tears [ 23 , 24 ]. Among the five types of MMRTs, type 2 is the most common [ 23 , 24 ].…”

Section: Medial Meniscus Posterior Root Tearmentioning

confidence: 99%

Medial Meniscus Posterior Root Tear: How Far Have We Come and What Remains?

et al. 2023

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Medial meniscus posterior root tears (MMRTs), defined as tears or avulsions that occur within 1 cm of the tibial attachment of the medial meniscus posterior root, lead to biomechanically detrimental knee conditions by creating a functionally meniscal-deficient status. Given their biomechanical significance, MMRTs have recently been gaining increasing interest. Accordingly, numerous studies have been conducted on the anatomy, biomechanics, clinical features, diagnosis, and treatment of MMRTs, and extensive knowledge has been accumulated. Although a consensus has not yet been reached on several issues, such as surgical indications, surgical techniques, and rehabilitation protocols, this article aimed to comprehensively review the current knowledge on MMRTs and to introduce the author’s treatment strategies.

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Meniscus extrusion is a predisposing factor for determining arthroscopic treatments in partial medial meniscus posterior root tears

Furumatsu

Kintaka

Higashihara

et al. 2023

Knee Surg & Relat Res

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Background Patients with partial medial meniscus posterior root tears (MMPRTs) sometimes require arthroscopic pullout repair because of their intolerable/repeated knee pains and continuous disturbance in gait during activities of daily living. However, the predisposing factors for future knee surgery in patients with partial MMPRTs remain unclear. We compared the findings of magnetic resonance imaging (MRI) between patients who underwent pullout repair and nonoperative management following partial MMPRTs. Methods Twenty-five patients who required arthroscopic repair for partial MMPRTs and 23 patients who were managed nonoperatively were evaluated during a mean follow-up period of 27.1 months. Sex, age, height, body weight, body mass index, duration from onset to initial MRI, MRI findings, and medial meniscus (MM) extrusion were compared between the two groups. Linear regression analysis was used to assess the correlation between MM extrusion and duration from onset to MRI examination. Results No significant differences were observed between the pullout repair and nonoperative management groups in terms of patient demographics and the positive ratio of MRI-based root tear signs. However, absolute MM extrusion in the pullout repair group (3.49 ± 0.82 mm) was larger than that in the nonoperative management group (2.48 ± 0.60 mm, P < 0.001). Extrusion of the MM (> 3 mm) was detected more frequently in the pullout repair group than in the nonoperative management group (P < 0.001). The odds ratio in the pullout repair and MM extrusion > 3 mm cases was 9.662. Linear regression analysis revealed a fair correlation between the duration from onset to MRI and MM extrusion only in the pullout repair group (0.462 mm/month increase in MM extrusion). Conclusions This study demonstrated that more severe MM extrusions were observed in the pullout repair group than in the nonoperative management group. Major extrusion (> 3 mm) was also observed more in the pullout repair group than in the nonoperative group. Assessing MM extrusion and its severity can help determine a valid treatment for patients with partial MMPRTs. Level of evidence IV, Retrospective comparative study.

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Early Surgical Repair of Medial Meniscus Posterior Root Tear Minimizes the Progression of Meniscal Extrusion: Response

Cited by 4 publications

References 11 publications

A characteristic MRI finding to diagnose a partial tear of the medial meniscus posterior root: an ocarina sign

A characteristic MRI finding to diagnose a partial tear of the medial meniscus posterior root: an ocarina sign

Medial Meniscus Posterior Root Tear: How Far Have We Come and What Remains?

Meniscus extrusion is a predisposing factor for determining arthroscopic treatments in partial medial meniscus posterior root tears

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