Posterior meniscus root tears: associated pathologies to assist as diagnostic tools

Matheny, Lauren M.; Ockuly, Andrew; Steadman, J. Richard; LaPrade, Robert F.

doi:10.1007/s00167-014-3073-7

Cited by 116 publications

(106 citation statements)

References 30 publications

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“…These findings have important implications on the treatment of ACL tears because of the relatively high percentage of patients who have LM posterior root tears associated with an ACL tear. 4,10,17 …”

Section: Discussionmentioning

confidence: 99%

Lateral Meniscus Posterior Root and Meniscofemoral Ligaments as Stabilizing Structures in the ACL-Deficient Knee: A Biomechanical Study

Frank

Moatshe

Brady

et al. 2017

Orthopaedic Journal of Sports Medicine

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122

119

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Background:The biomechanical effects of lateral meniscal posterior root tears with and without meniscofemoral ligament (MFL) tears in anterior cruciate ligament (ACL)–deficient knees have not been studied in detail.Purpose:To determine the biomechanical effects of the lateral meniscus (LM) posterior root tear in ACL-intact and ACL-deficient knees. In addition, the biomechanical effects of disrupting the MFLs in ACL-deficient knees with meniscal root tears were evaluated.Study Design:Controlled laboratory study.Methods:Ten paired cadaveric knees were mounted in a 6-degrees-of-freedom robot for testing and divided into 2 groups. The sectioning order for group 1 was (1) ACL, (2) LM posterior root, and (3) MFLs, and the order for group 2 was (1) LM posterior root, (2) ACL, and (3) MFLs. For each cutting state, displacements and rotations of the tibia were measured and compared with the intact state after a simulated pivot-shift test (5-N·m internal rotation torque combined with a 10-N·m valgus torque) at 0°, 20°, 30°, 60°, and 90° of knee flexion; an anterior translation load (88 N) at 0°, 30°, 60°, and 90° of knee flexion; and internal rotation (5 N·m) at 0°, 30°, 60°, 75°, and 90°.Results:Cutting the LM root and MFLs significantly increased anterior tibial translation (ATT) during a pivot-shift test at 20° and 30° when compared with the ACL-cut state (both Ps < .05). During a 5-N·m internal rotation torque, cutting the LM root in ACL-intact knees significantly increased internal rotation by between 0.7° ± 0.3° and 1.3° ± 0.9° (all Ps < .05) except at 0° (P = .136). When the ACL + LM root cut state was compared with the ACL-cut state, the increase in internal rotation was significant at greater flexion angles of 75° and 90° (both Ps < .05) but not between 0°and 60° (all Ps > .2). For an anterior translation load, cutting the LM root in ACL-deficient knees significantly increased ATT only at 30° (P = .007).Conclusion:The LM posterior root was a significant stabilizer of the knee for ATT during a pivot-shift test at lower flexion angles and internal rotation at higher flexion angles.Clinical Relevance:Increased knee anterior translation and rotatory instability due to posterior lateral meniscal root disruption may contribute to increased loads on an ACL reconstruction graft. It is recommended that lateral meniscal root tears be repaired at the same time as an ACL reconstruction to prevent possible ACL graft overload.

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Section: Discussionmentioning

confidence: 99%

Lateral Meniscus Posterior Root and Meniscofemoral Ligaments as Stabilizing Structures in the ACL-Deficient Knee: A Biomechanical Study

Frank

Moatshe

Brady

et al. 2017

Orthopaedic Journal of Sports Medicine

Self Cite

122

119

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“…Thus, the rate of meniscus injuries with ACL injury rests between 30 and 70%. Moreover, the medial meniscus is affected approximately twice as frequently as the lateral meniscus [9,11,18,24,36,50,55]. This is to be distinguished from "degenerative meniscus damage," in which tears develop within the meniscus without noteworthy trauma and under normal physiological stress.…”

Section: Introductionmentioning

confidence: 98%

The frequency of cartilage lesions in non-injured knees with symptomatic meniscus tears: results from an arthroscopic and NIR- (near-infrared) spectroscopic investigation

Spahn¹,

Plettenberg²,

Hoffmann³

et al. 2017

Arch Orthop Trauma Surg

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Through our investigations, a high, if not complete, concomitance of degenerative cartilage lesions and degenerative meniscus damage was demonstrated. From this it can be concluded that the entity of "isolated degenerative meniscus damage" clearly does not exist in practice. It is therefore highly probable that degenerative meniscus lesions, as a part of general joint degeneration, are to be interpreted in the context of the development of arthrosis. The practical consequences still are unclear. Patients after partial meniscectomy need a longer follow-up to detect potential cartilage lesions as well as an OA progression.

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“…LMPRTs have been identified as a combined injury with anterior cruciate ligament (ACL) ruptures in 7–12% of patients . Among patients with a tear of the ACL, male sex, and a contact injury mechanism are more common with an associated LMPRT .…”

mentioning

confidence: 99%

Complete tear of the lateral meniscus posterior root is associated with meniscal extrusion in anterior cruciate ligament deficient knees

Kamatsuki

Furumatsu

Fujii

et al. 2018

Journal Orthopaedic Research

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Posterior meniscus root tears: associated pathologies to assist as diagnostic tools

Abstract: IV.

Cited by 116 publications

References 30 publications

Lateral Meniscus Posterior Root and Meniscofemoral Ligaments as Stabilizing Structures in the ACL-Deficient Knee: A Biomechanical Study

Lateral Meniscus Posterior Root and Meniscofemoral Ligaments as Stabilizing Structures in the ACL-Deficient Knee: A Biomechanical Study

The frequency of cartilage lesions in non-injured knees with symptomatic meniscus tears: results from an arthroscopic and NIR- (near-infrared) spectroscopic investigation

Complete tear of the lateral meniscus posterior root is associated with meniscal extrusion in anterior cruciate ligament deficient knees

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