Most Patients Older Than 40 Years of Age Who Underwent Meniscal Root Repair Presented With an Effusion, a Positive McMurray Test, and a Positive Hyperflexion Test

Abstract

PurposeThe purpose of this study is to analyze the presenting symptoms and clinical exam findings of patients undergoing meniscal root repairs to aid physicians in diagnosing this injury. MethodsAll patients undergoing isolated arthroscopic meniscal root repair from 1/1/2016-9/1/2021 were identified. Patients under the age of 40 years were excluded. Clinical notes were reviewed for presenting symptoms and physical exam findings. Pre-operative radiographs were graded using the Kellgren-Lawrence (KL) scale for osteoarthritis. Root tears were graded using the radiographic criteria of Chung et al. and articular cartilage injury was graded using a validated system, AMADEUS (mean total Area Measurement And Depth & Underlying Structures). Results221 patients met inclusion criteria. 65.6% of patients reported that their pain began following an acute injury, with 39.4% of patients reporting a “pop”. On exam, an effusion was present in 71% of knees. McMurray test was reported positive in 85.5% and a positive hyperflexion test in 53.8% of knees. 49.5% of knees were graded KL 1. 154 had medial root tears, 10 had lateral root tears, and 24 suffered both root tears. 44.1% of tears occurred at the midsubstance of the root, with 28.0% occurring at the enthesis and 28.0% occurring at the root-posterior horn junction. The mean AMADEUS score was 94.4 ± 11.4. ConclusionWhile a majority of patients reported pain began following acute injury, less than half reported hearing a “pop”. When evaluating patients, an effusion, positive McMurray test, and positive hyperflexion test was present in the majority of meniscal root tears. Level of EvidenceLevel IV Diagnostic case series