Medial Meniscus Root Tear: Current Update Review

Abstract

This chapter mainly focuses on medial meniscus posterior root tear which is the point of attention nowadays because it is the common degeneration process and can lead to early-onset osteoarthritis of the knee without treatment. The biomechanics of the medial meniscus root tear is similar to total meniscectomy. Hence, early detection and diagnosis will lead to better outcome. Most cases with medial meniscus root tear also have degenerative change of the knee. Meniscal extrusion is a common finding in magnetic resonance imaging (MRI) which represent impairing of hoop stress function of the meniscus. Patient selection and understanding of the natural history of the disease is a particularly important. Options for the treatment including conservative treatment, surgical treatment such as partial meniscectomy, meniscus root repair, or reduction of meniscal extrusion. Outcome of these treatments are variable depending on the condition of the patients. Long term outcome of surgical treatment revealed lower rate of knee replacement compared with conservative treatment.

Meniscus root tears: state of the art

“…Meniscal root tears account for about 20% of all meniscal tears, representing a significant component within the spectrum of meniscus pathologies [ 3 , 8 ]. Degenerative medial meniscus posterior root tears represent the most commonly reported subtype among meniscus tears.…”

“…Degenerative medial meniscus posterior root tears represent the most commonly reported subtype among meniscus tears. It is noteworthy that around 80% of all medial meniscus root tears were found in individuals who were obese with a sedentary lifestyle and those who were older than 50 years of age [ 1 , 8 ]. Despite the contribution of these injuries to degenerative joint disease, they are often undiagnosed at initial presentation [ 2 , 9 ].…”

“…Additionally, McMurray and Thessaly tests might be positive. Given the potential concomitance with other knee injuries, it is imperative to always conduct a comprehensive knee examination, especially with high-grade pivot shift and anterior drawer tests [ 8 , 27 ].…”

Surgical Management of Traumatic Meniscus Injuries

“…Meniscal root tears can be defined as either a radial tear within 1 cm of the root attachment, or a complete avulsion of the meniscal root from the tibia. If the meniscal roots are torn, the stability of the entire meniscus is compromised and it is equivalent to a total meniscectomy [14,18,32], which indicates the total loss of the biomechanical function of the meniscus. (Figure 2C) For this reason, meniscal root tears in younger patients often benefit from surgical repair, which mitigates the risk of osteoarthritis progression and restores proper biomechanics to the knee joint.…”