Age, male sex, higher posterior tibial slope, deep sulcus sign, bone bruises on the lateral femoral condyle, and concomitant medial meniscal tears are risk factors for lateral meniscal posterior root tears: a systematic review and meta-analysis

Abstract

PurposeLateral meniscus posterior root tears (LMPRTs) are commonly found in patients with anterior cruciate ligament (ACL) injuries. However, risk factors for LMPRTs are not well known. This study was designed to systematically review the available evidence regarding risk factors associated with LMPRTs. MethodsThe PubMed, EMBASE, Cochrane Library, and Web of Science databases were searched for papers containing the key words “lateral meniscus posterior root tears”, “LMPRTs” and “risk factor”. Inclusion screening, data extraction, and quality assessment of the included articles were conducted independently by two authors. Statistical analysis was conducted to determine risk factors for LMPRTs. ResultSeventeen studies with a total sample size of 6, 589 patients were identified. The pooled prevalence of LMPRTs was 9.6% (range, 5.1–33.8%) for ACL injury. Significant risk factors included a patient age of < 30 [OR = 1.4, 95% CI (1.07, 1.84), p = 0.01], male sex [OR = 1.50, 95% CI (1.24,1.81), p = 0.01], higher body mass index (BMI) [MD = 0.45, 95% CI (0.13, 0.76), p < 0.01], higher lateral posterior tibial slope (LPTS) [MD = 2.22, 95% CI (1.37, 3.07), p < 0.01], deep sulcus sign [OR = 5.76, 95% CI (1.35, 24.52), p < 0.01] and bone bruises on lateral femoral condyle [OR = 4.88, 95% CI (1.27, 18.77), p < 0.01], lateral meniscal extrusion > 1 mm [OR = 5.56, 95% CI (1.52, 20.29), p < 0.01] and > 3 mm [OR = 12.91 95% CI (1.28, 130.01), p < 0.01], medial meniscal tears [OR = 1.40, 95% CI (1.12, 1.75), p < 0.01], and medial ramp lesions [OR = 2.29, 95% CI (1.35, 3.89), p < 0.01]. ConclusionAge below 30, male, higher BMI, higher LPTS, deep sulcus sign, bone bruises on lateral femoral condyle, lateral meniscal extrusion, medial meniscal tear, and medial ramp lesion are risk factors for LMPRTs. Level of evidenceLevel IV.

Risk factors for the long-term incidence and progression of knee osteoarthritis in older adults: role of nonsurgical injury

“…Hence, knees with no injury at inclusion but experiencing new injuries showed higher osteoarthritis structural alterations in both medial and lateral meniscal extrusion and cartilage volume loss, as well as an increased medial BML size. These data concur with studies reporting that a medial meniscal lesion is a strong risk factor for the occurrence of lateral lesions, 37 , 38 in addition to those reporting that meniscal extrusion and BML predict incident and progressive knee osteoarthritis. 26 , 28 , 39 – 41 The increased BML size may have been a direct consequence of a bone injury, a meniscal extrusion and a possible rupture of the anterior cruciate ligament.…”

Decreased posterior tibial slope is a risk factor for primary posterior cruciate ligament rupture and posterior cruciate ligament reconstruction failure: A systematic review

“…Unaddressed joint laxity may be a result of variations in the anatomy of patients. Knee morphological features contributing to primary and secondary injuries have been extensively investigated and identified in ACL and meniscus research [6][7][8], but are less commonly researched in the field of PCL injuries.…”

Increased lateral femoral condyle ratio measured by MRI is associated with higher risk of solitary meniscus injury

“…The injury results in biomechanical disruption of the knee and worse long-term clinical outcomes ( Zhou, 2018 ; Li et al, 2020a ; Bradley et al, 2023 ). Therefore, more and more scholars have begun to pay more attention to the prevention and treatment of meniscal injuries and to understand the risk factors for meniscal injuries ( Snoeker et al, 2013 ; Wu et al, 2022 ). Early assessment and identification are necessary to reduce the incidence of injury and the cartilage wear and early osteoarthritis of the knee caused by long-term injury.…”