Abstract
BackgroundMedial meniscus posterior root tear can result in medial meniscus extrusion. However, the severity of medial meniscus extrusion is different in each root tear patient. The purpose of this study was to identify the factors that contribute to the severity of medial meniscus extrusion with medial meniscus posterior root tear, such as duration of disease, the degree of arthritis—chondral wear, subchondral edema, osteophyte size, and Kellgren–Lawrence (K/L) grade—and mechanical alignment for appropriate treatment method.MethodsFrom January 2009 to August 2014, we retrospectively analyzed magnetic resonance imaging (MRI) and simple x-ray of 99 patients with medial meniscus posterior root tear. The duration of the disease was identified through retrospective chart review. The severity of medial meniscus extrusion, the presence of subchondral edema, the degree of chondral wear, and the size of the osteophyte were measured on MRI. K/L grade was confirmed on simple x-ray, and the mechanical axis was measured on whole extremity radiographs. Statistical analysis was performed by using bivariate correlation analysis and one-way analysis of variance.ResultsThe mean medial meniscus extrusion was 4.61 mm, and the mean duration of the disease was 15.52 months. The mean degree of chondral wear was 25.8%, and 63 out of 99 cases showed subchondral edema. The average alignment was 4.30 degrees, and the average size of the osteophyte was 1.48 mm. There were 40 cases (40.4%) with K/L grade I, 48 cases (48.5%) with grade II, 11 cases (11.1%) with grade III, and no cases with grade IV. In the group mean analysis between the K/L grade and the severity of medial meniscus extrusion, the average medial meniscus extrusions were 3.97 mm in grade I, 4.93 mm in grade II, and 5.59 mm in grade III. There was a statistical significance between the size of the osteophyte and the severity of medial meniscus extrusion (P = 0.000), K/L grade, and the severity of medial meniscus extrusion (P = 0.001).ConclusionsThe severity of medial meniscus extrusion with medial meniscus posterior horn root tear is associated with the size of the osteophyte and K/L grade.
Highlights
Medial meniscus posterior root tear can result in medial meniscus extrusion
The purpose of this study is to investigate the factors that affect the severity of medial meniscus extrusion in medial meniscus posterior root tear on coronal plane magnetic resonance imaging (MRI), such as duration of disease, the degree of arthritis, and mechanical alignment for appropriate treatment of the medial meniscus posterior root tear
There was no Discussion This study assessed the relationship between duration of disease, alignment, subchondral edema, degree of chondral wear, size of osteophyte, and Kellgren– Lawrence (K/L) grade and the severity of the medial meniscus extrusion in posterior root tear
Summary
Medial meniscus posterior root tear can result in medial meniscus extrusion. The purpose of this study was to identify the factors that contribute to the severity of medial meniscus extrusion with medial meniscus posterior root tear, such as duration of disease, the degree of arthritis—chondral wear, subchondral edema, osteophyte size, and Kellgren– Lawrence (K/L) grade—and mechanical alignment for appropriate treatment method. The medial meniscus posterior horn is strongly attached to the tibial spine by the root and is the primary structure to maintain the hoop tension during loading [4]. The medial meniscus posterior root tear leads to abnormal biomechanics of the tibiofemoral joint and the inability to convert axial loads into hoop stresses by inducing radial displacement of the medial meniscus, called the medial meniscus extrusion [5]. Restoration of meniscal continuity is becoming the standard of care for posterior meniscal root pathology
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