Inferiorly Displaced Flap Tears of the Medial Meniscus

Lecas, Lynn K.; Helms, Clyde A.; Kosarek, Frank J.; Garret, William E.

doi:10.2214/ajr.174.1.1740161

Cited by 67 publications

(36 citation statements)

References 8 publications

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“…In our series, the displaceable flap tears were found in 75 knees (75%) during arthroscopy. The clinical significance of a flap tear is that it can be displaced centrally or peripherally, leading to mechanical symptoms, which requires arthroscopic management19202122). Given that displaceable flap tears cause mechanical symptoms, it was hypothesized that 1) HCTs with a flap tear would be more symptomatic than HCTs without a flap tear, and 2) resultantly clinical outcomes after meniscectomy would be better in patients having combined flap tears compared to patients without flap tears.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic Meniscectomy for Medial Meniscus Horizontal Cleavage Tears in Patients under Age 45

Kim

Lee

Chay

et al. 2016

Knee Surg Relat Res

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PurposeThe purpose of this study was to evaluate the demographics, clinical features, and outcomes of arthroscopic partial meniscectomy (APM) for isolated medial meniscus horizontal cleavage tears (MMHCTs) in patients under 45 years of age.Materials and MethodsWe retrospectively reviewed 98 patients (100 knees) under 45 years who underwent APM for MMHCTs. Clinical outcomes were assessed using International Knee Document Committee (IKDC) subjective core, Tegner activity scale, visual analog scale (VAS) pain score, and a question on the symptom relief.Results79% were male and 70% had no trauma. The mean symptom duration was 10 months. At arthroscopy, a flap tear was identified in 75%. At a mean of 19-month follow-up, the IKDC subjective score, Tegner activity scale, and VAS pain score were significantly improved compared to the preoperative values (p=0.025, p=0.043, and p=0.032, respectively). While 85% were free of symptoms, 15% had persistent pain. No significant differences in outcomes were observed based on the tear type and the presence of flap tears. No progression or development of radiographic degenerative changes was observed in all knees.ConclusionsDemographics of MMHCTs under age 45 showed a male dominance and higher frequency of non-traumatic tears. APM was beneficial to symptomatic HCTs in this cohort during the short-term follow-up. Type of HCTs and combined flap tears did not affect clinical outcomes.

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Section: Discussionmentioning

confidence: 99%

Arthroscopic Meniscectomy for Medial Meniscus Horizontal Cleavage Tears in Patients under Age 45

Kim

Lee

Chay

et al. 2016

Knee Surg Relat Res

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“…Lecas et al .,[11] in a review of 3686 MRI examinations of the knee, reported 11 cases of torn meniscal fragments displaced inferiorly between the MCL and tibia. They also mentioned that semimembranosus tendon can be mistaken for such displaced meniscal fragments.…”

Section: Discussionmentioning

confidence: 99%

MRI imaging of displaced meniscal tears: Report of a case highlighting new potential pitfalls of the MRI signs

Prasad

Brar

Rana

2014

Indian Journal of Radiology and Imaging

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Magnetic resonance imaging (MRI) has been found to be an excellent imaging tool for meniscal injuries. Various MRI signs have been described to detect displaced meniscal injuries, specifically the bucket-handle tears. Although these signs are quite helpful in diagnosing meniscal tears, various pitfalls have also been reported for these signs. Double anterior cruciate ligament (ACL) sign refers to presence of a linear hypointense soft tissue anterior to the ACL, which represented the flipped bucket-handle tear of the meniscus. Disproportional posterior horn and flipped meniscus signs represent asymmetrically thickened horns of the menisci due to overlying displaced meniscal fragments. We report a case wherein MRI of the knee showed tear and displacement of the medial patellofemoral ligament (MPFL) and vastus medialis complex, medial collateral ligament (MCL), and posterior cruciate ligament (PCL) mimicking these signs. To our knowledge, internally displaced MPFL and MCLs have not been described as mimics for displaced meniscal fragments.

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“…In addition, extrusion of a part of the meniscus into the coronary recess below the joint line is seen on coronal as well as sagittal images. 38,49 These tears often present clinically with mechanical locking. It is important to identify the fragments before surgery, as the retention of meniscal flap often results in persistent pain and locking.…”

Section: Flap Tearmentioning

confidence: 99%

MR imaging of meniscal tears

et al. 2017

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Background: Menisci transmit the forces across the joint and cushion the mechanical loading of the joint. Thus, it is important to identify meniscal tear. A thorough understanding of normal meniscal anatomy and surrounding structure is critical for diagnosis. Magnetic resonance imaging is the current modality of choice providing fine resolution and multi-planar imaging for identifying the meniscal injuries and the various pattern of tear, helping to plan the subsequent management. The purpose of the work was to study the role of MRI in classifying the meniscal injuries.Methods: MRI Knee of 136 patients with meniscal injuries was studied. All the MR imaging scans were performed on 1.5-T MR system (Siemens magnetom Essenza).Results: A total of 136 patients were studied in which majority of the patient’s i.e. 90.44 % had medial meniscal tear while 18.38 % patients had lateral meniscal tear. Both medial and lateral meniscal tears were found in 8.82 % patients. Among the different types of tears, horizontal tear was the most common tear in both medial and lateral meniscus comprising 52.8 % and 52 % respectively. The tears being most common in the age group 41-50years. There were associated injuries to the other ligaments of the knee joint along with meniscal tear, ACL tear being the most common and was seen in 50% of patients.Conclusions: MRI is a good modality for classifying meniscal injury and evaluation of injuries to the associated ligaments. Secondary signs are good predictors of underlying meniscal tear in equivocal cases.

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Inferiorly Displaced Flap Tears of the Medial Meniscus

Cited by 67 publications

References 8 publications

Arthroscopic Meniscectomy for Medial Meniscus Horizontal Cleavage Tears in Patients under Age 45

Arthroscopic Meniscectomy for Medial Meniscus Horizontal Cleavage Tears in Patients under Age 45

MRI imaging of displaced meniscal tears: Report of a case highlighting new potential pitfalls of the MRI signs

MR imaging of meniscal tears

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