Meniscal Root Tears: Diagnosis and Treatment

Koenig, Jonathan H.; Ranawat, Anil S.; Umans, Hilary; DiFelice, Gregory S.

doi:10.1016/j.arthro.2009.03.015

Cited by 187 publications

(146 citation statements)

References 29 publications

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“…A study by Lee et al (7) reported a very high prevalence of chondral lesions of the medial femoral condyle in knees with medial PMRTs. Their findings are in agreement with a cross-sectional aspect of the present loss of the structure that most robustly holds the meniscus in the normal anatomic position (2). Risk factors for meniscal root tears include female sex, high BMI, greater varus mechanical axis angle, and low levels of exercise (21).…”

Section: Resultssupporting

confidence: 77%

“…Previous studies based on MR imaging and arthroscopic findings showed cross-sectional associations between medial meniscal root tears and medial tibiofemoral cartilage loss (2,5,(7)(8)(9). However, these studies were based on a relatively small sample of subjects and were not longitudinal.…”

Section: Subjectsmentioning

confidence: 84%

“…Subjects were not eligible to participate in the MOST study if they had rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, reactive arthritis, renal insufficiency that required hemodialysis or peritoneal dialysis, or a history of cancer (except for nonmelanoma types of skin cancer); underwent or planned T he meniscal roots are ligamentous attachments that anchor the anterior and posterior horns of the meniscus to the tibial plateau (Fig 1) (1). Tears of the meniscal roots are distinctly different from tears of the anterior or posterior horn of the meniscus (2). Root tears may or may not be associated with tears of the meniscus, and isolated root tears can occur with no tearing of the meniscus itself (3).…”

Section: Subjectsmentioning

confidence: 99%

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Medial Posterior Meniscal Root Tears Are Associated with Development or Worsening of Medial Tibiofemoral Cartilage Damage: The Multicenter Osteoarthritis Study

Guermazi

Hayashi²,

Jarraya³

et al. 2013

Radiology

113

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MPH Purpose:To assess the association of meniscal root tear with the development or worsening of tibiofemoral cartilage damage. Materials and Methods:Institutional review board approval and written informed consent from all subjects were obtained. A total of 596 knees with radiographically depicted osteoarthritis were randomly selected from the Multicenter Osteoarthritis study cohort. Cartilage damage was semiquantitatively assessed by using the Whole-Organ Magnetic Resonance Imaging Score (WORMS) system (grades 0-6). Subjects were separated into three groups: root tear only, meniscal tear without root tear, and neither meniscal nor root tear. A log-binomial regression model was used to calculate the relative risks for knees to develop incident or progressing cartilage damage in the root tear group and the meniscal tear group, with the no tear group serving as a reference. Results:In the medial tibiofemoral joint, there were 37 knees with isolated medial posterior root tear, 294 with meniscal tear without root tear, and 264 without meniscal or root tear. There were only two lateral posterior root tears, and no anterior root tears were found. Thus, the focus was on the medial posterior root tear. Conclusion:Isolated medial posterior meniscal root tear is associated with incident and progressive medial tibiofemoral cartilage loss.q RSNA, 2013

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Section: Resultssupporting

confidence: 77%

Section: Subjectsmentioning

confidence: 84%

Section: Subjectsmentioning

confidence: 99%

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Medial Posterior Meniscal Root Tears Are Associated with Development or Worsening of Medial Tibiofemoral Cartilage Damage: The Multicenter Osteoarthritis Study

Guermazi

Hayashi²,

Jarraya³

et al. 2013

Radiology

113

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“…5,19,20 After posterior root tears of the medial and lateral menisci, there is a significant increase in tibiofemoral contact pressure concomitant with decreased contact areas, 2,13,19,20,22 with one study reporting that posterior root tears simulate a state of total meniscectomy.2 Therefore, the current treatment of choice for meniscal root injuries is primary repair by use of either a transtibial bone tunnel or a suture anchor for fixation of the root to bone. 7,14,16,21 The literature suggests that existing surgical techniques for meniscal root repair fail to restore the biomechanical properties of repaired meniscus tissue to its native state at time zero. 6,7,8,18 Feucht et al 7 reported that neither the transtibial pullout nor suture anchor technique was able to adequately restore biomechanical properties of the native posterior medial (PM) meniscal root.…”

mentioning

confidence: 99%

Structural Properties of the Meniscal Roots

et al. 2014

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“…This type of injury characteristically becomes clinically asymptomatic within the short term, 1 although theoretically, most of the meniscus hoop stress is lost. 2 In addition, only mild lateral joint-space narrowing was measured without significant differences in subjective or objective scores compared with controls at a mean of 10 years of follow-up of posterior lateral meniscus root tears left in situ. 3 Therefore, partial meniscectomy or being left in situ is the conventionally selected treatment for unstable full radial posterior lateral meniscus tears.…”

mentioning

confidence: 99%

An All-Inside Repair for Full Radial Posterior Lateral Meniscus Tears

Soejima

Tabuchi

Noguchi

et al. 2016

Arthroscopy Techniques

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There is controversy about the treatment for unstable full radial posterior lateral meniscus tears, particularly that involving the posterior root. Some surgeons have advocated repairing these types of meniscus tears using various techniques, but their methods are somewhat technical. We developed the technique for an all-inside repair for full radial posterior lateral meniscus tears using the Meniscal Viper (Arthrex, Naples, FL). A doubled thread is passed through 1 edge of the radial tear by the Meniscal Viper and is kept in place without tying the knot. The Meniscal Viper is used again to set a new thread, repeating the same procedure to another edge of the tear. At this step, 2 doubled threads are passed through each stump of the tear, and both a loop end and 2 free ends of each thread are located outside of the joint. Then, 2 doubled threads pass the third thread into its own loop, pulling it out. Finally, the third thread becomes the mattress suture over the radial tear site and is fastened by sliding knot techniques. This procedure makes it easy to strictly, smoothly, and less invasively shorten the gap by drawing each stump of the meniscus in the direction of the circumference.

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Meniscal Root Tears: Diagnosis and Treatment

Cited by 187 publications

References 29 publications

Medial Posterior Meniscal Root Tears Are Associated with Development or Worsening of Medial Tibiofemoral Cartilage Damage: The Multicenter Osteoarthritis Study

Medial Posterior Meniscal Root Tears Are Associated with Development or Worsening of Medial Tibiofemoral Cartilage Damage: The Multicenter Osteoarthritis Study

Structural Properties of the Meniscal Roots

An All-Inside Repair for Full Radial Posterior Lateral Meniscus Tears

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