The role of MRI in evaluation of arthroscopic transtibial pullout repair for medial meniscus posterior root tears

Oliveira, Camila Vilela de; Lôbo, Carlos Felipe Teixeira; Helito, Paulo Victor Partezani; Bordalo-Rodrigues, Marcelo; Helito, Camilo Partezani

doi:10.1016/j.clinimag.2021.02.029

Cited by 9 publications

(1 citation statement)

References 41 publications

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“…Bae et al calculated the diagnostic value of popping accompanied by pain for MMPRT, with a diagnostic accuracy of 77.9% [1]. In addition to clinical symptoms, magnetic resonance imaging (MRI) examination is essential [27]. The radial tear sign (radial linear defect) in the axial slices and the cleft sign (a vertical linear root defect) or giraffe neck sign (giraffe neck‐like shape of the MM posterior segment) in coronal slices and the ghost sign (disappearance of the MM posterior root/horn on some slices) on sagittal slices have been reported as useful signs for diagnosing MMPRT with high sensitivity [3, 8, 18].…”

Section: Introductionmentioning

confidence: 99%

Increased cleft width during knee flexion is useful for the diagnosis of medial meniscus posterior root tears

Hiranaka

Kamatsuki

Miyazawa

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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PurposeThis study aimed to evaluate changes in the cleft width, defined as the distance between the lateral edge of the medial tibial plateau and that of the medial meniscus (MM) posterior root, using open magnetic resonance imaging (MRI) in patients with MM posterior root tear (MMPRT). MethodsThis study included 25 patients (20 women and 5 men; mean age: 65.2 years) who were diagnosed with MMPRT and underwent pullout repair. Upon coronal imaging, the cleft width was evaluated at the 10° and 90° flexed knee positions. The difference in the cleft width (defined as the cleft width at 90° minus the cleft width at 10°) was also calculated. Upon sagittal imaging, the MM posterior extrusion (MMPE) at 90° was also evaluated. Separate univariate linear regression models were used to determine the association between the time from injury to MRI and radiographic measurements. ResultsThe mean cleft width at 10° and 90° was 4.9 ± 2.6 mm and 7.4 ± 3.7 mm, respectively; the mean difference in cleft width was 2.5 ± 1.5 mm, and the mean MMPE at 90° was 3.7 ± 1.3 mm. There was a significant difference in cleft width at 10° and 90° (p < 0.001). The time from injury to MRI was significantly associated with the cleft width at 10° (R = 0.42; p = 0.023), cleft width at 90° (R = 0.59; p = 0.002), the difference in the cleft width (R = 0.62; p = 0.008), and MMPE at 90° (R = 0.53; p = 0.008). ConclusionThis study demonstrates that the cleft width is significantly larger during knee flexion than during knee extension. Increased cleft width during knee flexion (“graben” sign) may help diagnose MMPRT, especially in cases where the cleft sign is unclear during knee extension. Level of evidenceIII.

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Section: Introductionmentioning

confidence: 99%

Increased cleft width during knee flexion is useful for the diagnosis of medial meniscus posterior root tears

Hiranaka

Kamatsuki

Miyazawa

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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More than 3 mm of preoperative medial meniscal extrusion is identified as a key risk factor for varus progression in limb alignment after arthroscopic repair of medial meniscus posterior root tear

Yoon,

Bae,

Ahn

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeTo investigate the risk factors for varus progression after arthroscopic medial meniscal posterior root tear (MMPRT) repair and to compare the clinical outcomes between two groups: one with more varus progression and the other with less varus progression.MethodsPatients who underwent isolated arthroscopic repair of MMPRT between 2015 and 2020 were enroled, and 2‐year follow‐up data were collected. Participants were categorized into two groups based on preoperative values of the weight‐bearing line (WBL) ratio: group A with <5.9% increase and group B with ≥5.9% increase. Various factors, including demographic features and radiological findings, were analysed and compared between the two groups. Intra‐meniscal signal intensity, meniscal healing, medial meniscal extrusion (MME), and articular cartilage grade were assessed preoperatively and 1‐year postoperatively using coronal magnetic resonance imaging.ResultsThe final cohort consisted of 34 patients in group A and 46 in group B, with a mean age of 55.8 ± 11.2 and 59.8 ± 6.6 years, respectively. Preoperative WBL ratio and cartilage lesions in the medial compartment did not differ between the groups. Preoperative MME were significantly lower in group A than those in group B (2.6 ± 0.6 mm in group A and 3.5 ± 0.7 mm in group B, p < 0.05). Patient‐reported outcomes at the 2‐year follow‐up did not differ between the two groups (n. s.). In a logistic analysis, the odds ratio of MME was 2.1 (p < 0.05), and the cutoff value of MME was 3.02 mm.ConclusionPreoperative MME is a risk factor for varus progression. However, no differences in patient‐reported outcomes were observed at 2‐year follow‐up, even in the group with greater varus progression.Level of EvidenceLevel IV.

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Outcomes of Arthroscopic All-Inside Repair Are Improved Compared to Transtibial Pull-Out Repair of Medial Meniscus Posterior Root Tears

Yoon

Lee

Park

2023

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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The role of MRI in evaluation of arthroscopic transtibial pullout repair for medial meniscus posterior root tears

Cited by 9 publications

References 41 publications

Increased cleft width during knee flexion is useful for the diagnosis of medial meniscus posterior root tears

Increased cleft width during knee flexion is useful for the diagnosis of medial meniscus posterior root tears

More than 3 mm of preoperative medial meniscal extrusion is identified as a key risk factor for varus progression in limb alignment after arthroscopic repair of medial meniscus posterior root tear

Outcomes of Arthroscopic All-Inside Repair Are Improved Compared to Transtibial Pull-Out Repair of Medial Meniscus Posterior Root Tears

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