The role of meniscal root pathology and radial meniscal tear in medial meniscal extrusion

Lerer, Daniel; Umans, Hilary; Hu, Minyi; Jones, Morgan H.

doi:10.1007/s00256-004-0761-2

Cited by 373 publications

(324 citation statements)

References 7 publications

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“…There is a significant association between the presence of pathologic meniscal extrusion and moderate to large osteophytes or cartilage loss [25][26][27]. Meniscal extrusion may be related to a loss of meniscal function, and may be one of the first signs of OA, due to a loss of meniscal function, appearing before cartilage thinning.…”

Section: Meniscal Extrusionmentioning

confidence: 99%

Magnetic Resonance Imaging is not suitable for interpretation of meniscal status ten years after arthroscopic repair

Pujol

Tardy

Boisrenoult

et al. 2013

International Orthopaedics (SICOT)

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Purpose The purpose of this study was to assess the MRI features of the all-inside repaired meniscus in the long-term. Methods Among 27 consecutive all-inside arthroscopic meniscal repairs, 23 patients aged 25±5 years at the time of surgery were reviewed at a median follow-up of 10±1 years. Retrospective clinical examinations and imaging assessments using a 1.5-T MRI after all-inside arthroscopic meniscal repair were conducted. Results At follow-up, Lysholm and IKDC averaged 89±11 and 95±8, respectively. MRI examinations revealed no meniscal signal alteration in three patients (13 %), a vertical signal located in the previously torn area in seven (30 %), a horizontal grade 3 in nine (39 %), and a complex tear (grade 4) in four (17.5 %). There were no differences between medial and lateral menisci (p=0.15), stable and stabilised knees (p=0.56). Conclusions Several abnormal vertical and/or horizontal hypersignals are still present on MRI examination ten years after arthroscopic all-inside meniscal repair. The appearance of early signs of osteoarthritis is rare, suggesting a chondroprotective effect of the repaired meniscus.

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Section: Meniscal Extrusionmentioning

confidence: 99%

Magnetic Resonance Imaging is not suitable for interpretation of meniscal status ten years after arthroscopic repair

Pujol

Tardy

Boisrenoult

et al. 2013

International Orthopaedics (SICOT)

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“…Subjects were participants in the Multicenter Osteoarthritis (MOST) study, a prospective epidemiologic study of 3026 people aged 50-79 years (overall mean age, 62.5 years) with a goal of identifying risk factors for incident and progressive knee OA in a population either with or at high risk of developing considered by many authors as the most relevant factor associated with extrusion of the meniscus (25,(27)(28)(29), it has been demonstrated that several types of meniscal tears, including nonroot tears, are also related to meniscal extrusion (23,24,30). Magnetic resonance (MR) imaging has become established as the most important imaging modality in the assessment of knee pathologic findings, exhibiting excellent diagnostic performance in the detection of meniscal pathologic abnormalities (31,32).…”

Section: Study Design and Subjectsmentioning

confidence: 99%

Factors Associated with Meniscal Extrusion in Knees with or at Risk for Osteoarthritis: The Multicenter Osteoarthritis Study

Crema

Roemer²,

Felson³

et al. 2012

Radiology

190

172

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Purpose:To assess the associations of meniscal tears, knee malalignment, cartilage damage, knee effusion, and body mass index with meniscal extrusion. Materials and Methods:The Multicenter Osteoarthritis study is an observational study of individuals who have or are at risk for knee osteoarthritis (OA). The HIPAA-compliant protocol was approved by the institutional review boards of all participating centers, and written informed consent was obtained from all patients. All subjects with available baseline knee radiographs and magnetic resonance (MR) images were included. MR imaging assessment of meniscal morphologic characteristics, meniscal position, and cartilage morphologic characteristics with use of the Whole-Organ Magnetic Resonance Imaging Score system was performed by two musculoskeletal radiologists. Cross-sectional associations of severity of meniscal tears, knee malalignment, tibiofemoral cartilage damage, knee effusion, and body mass index with meniscal extrusion were assessed by using logistic regression, with multiadjustments when testing each predictor. Results:A total of 1527 subjects (2131 knees; 2116 medial and 2106 lateral menisci) were included. Medially, meniscal tears, varus malalignment, and cartilage damage were associated with meniscal extrusion, with odds ratios (ORs) of 6.3 (95% confidence interval [CI]: 5.0, 8.0), 1.3 (95% CI: 1.1, 1.7), and 1.8 (95% CI: 1.4, 2.2), respectively. Laterally, meniscal tears, valgus malalignment, and cartilage damage were associated with meniscal extrusion, with ORs of 10.3 (95% CI: 7.1, 14.9), 2.2 (95% CI: 1.5, 3.2), and 2.0 (95% CI: 1.3, 2.9), respectively. Conclusion:Meniscal tears are not the only factors associated with meniscal extrusion; other factors include knee malalignment and cartilage damage. Meniscal extrusion is probably an effect of the complex interactions among joint tissues and mechanical stresses involved in the OA process.q RSNA, 2012

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“…The load transmission function is maintained by the hoop strain mechanism of the meniscus and crucial to prevent degenerative changes [4,11]. A complete posterior medial meniscus root tear results in the failure of the hoop strain mechanism and a loss of the ability to resist extrusion under axial loading [17]. Such type of tear is biomechanically equivalent to a total meniscectomy [4,10].…”

Section: Introductionmentioning

confidence: 99%

Meniscus root refixation technique using a modified Mason–Allen stitch

Lee

Jang

et al. 2012

Knee Surg Sports Traumatol Arthrosc

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A complete posterior medial meniscus root tear results in the inability to withstand hoop stress and requires the repair of the posterior medial meniscus root. Several techniques to repair the posterior medial meniscus root have been proposed, but most techniques are based on simple stitching. A modified Mason-Allen technique, recognized as a superior stitching method to repair rotator cuff in shoulder surgery, was applied to overcome the potential weakness of those simple stitching techniques. This newly modified Mason-Allen technique reproduces the locking effect of a conventional modified Mason-Allen stitch allowing the physiological meniscal extrusion. The purpose of this article is to describe a posterior root repair technique using a modified Mason-Allen stitch with two strands consisting of a simple horizontal and a simple vertical stitch. Level of evidence V.

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The role of meniscal root pathology and radial meniscal tear in medial meniscal extrusion

Cited by 373 publications

References 7 publications

Magnetic Resonance Imaging is not suitable for interpretation of meniscal status ten years after arthroscopic repair

Magnetic Resonance Imaging is not suitable for interpretation of meniscal status ten years after arthroscopic repair

Factors Associated with Meniscal Extrusion in Knees with or at Risk for Osteoarthritis: The Multicenter Osteoarthritis Study

Meniscus root refixation technique using a modified Mason–Allen stitch

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