Preliminary diagnosis of medial meniscus posterior root tears using the Rosenberg radiographic view

Abstract

Purpose: To verify the effectiveness of detecting medial meniscus posterior root tears (MMPRTs) using weightbearing posterior-anterior (PA) radiographs. Materials and methods: Twenty-three patients were diagnosed with an MMPRT using magnetic resonance imaging (Group A), with 23 matched individuals forming the control group (Group B). The distance between medial tibial eminence and the lateral edge of the medial femoral condyle (MTE-MFC distance) and medial joint space (MJS) width were measured on weight-bearing PA radiographs, with the knee flexed at 45°(Rosenberg view). Absolute medial meniscus extrusion (MME) was measured on magnetic resonance images. Results: The MTE-MFC distance was greater and the MJS width was smaller in Group A than Group B (7.7 ± 1.7 mm versus 6.0 ± 1.24 mm and 3.2 ± 0.8 mm versus 4.5 ± 0.7 mm, respectively; P < 0.05). The MTE-MFC distance and MJS width correlated with MME (r = 0.603 and 0.579, respectively; P < 0.05), and the extent of MME was greater in Group A than Group B (4.1 ± 1.1 mm versus 1.8 ± 1.5 mm, respectively; P < 0.05). Conclusions: MMPRTs increase the MTE-MFC distance and decrease the MJS width, with these measurements correlating to the MME. Therefore, measurement of the MTE-MFC distance and MJS width on the Rosenberg view could be a useful preliminary method for the diagnosis of an MMPRT.

Root Repair Versus Partial Meniscectomy for Medial Meniscus Posterior Root Tears: Comparison of Long-term Survivorship and Clinical Outcomes at Minimum 10-Year Follow-up

“…Medial meniscus posterior root tears (MMPRTs) are defined as an avulsion injury or radial tear occurring in the posterior bony attachment. 3,18,21 Detachment of the posterior root completely disrupts the continuity of the circumferential fibers, leading to loss of hoop tension, loss of load sharing ability, and unacceptable peak pressures. Biomechanical studies have shown that MMPRT has the same consequences as a total meniscectomy and that the pathological loads lead to degenerative arthritis.…”

Transtibial pullout repair of medial meniscus posterior root tears: effects on the meniscus healing score and ICRS grade among patients with mild osteoarthritis of the knee

“…In the case of an MMPRT, MM extrudes medially and posteriorly [12,23]. Therefore, medial and posterior buttress function is lost even if the anterior and posterior cruciate ligaments remain intact and the femur and tibia are subluxated with knee flexion [3,22]. With this in mind, the changes in cartilage damage in the femur and tibia in the anteroposterior and mediolateral directions were evaluated; a high meniscus score at the time of second-look arthroscopy, at 1 year after MMPRT surgery, should indicate the restoration of lost medial and posterior buttress function.…”

“…The MFC was divided into nine areas and the MTP was divided into five areas (Figures 1a, e). Cartilage damage was documented in detail at the time of primary surgery and second-look arthroscopic examination [22]. Subsequently, the MFC was divided into six zones (A-F) (Figures 1b, c): the anterior, central, posterior, medial, central, and lateral zones; the MTP was divided into two zones (G and H) (Figures 1f, g): the anterior to posterior and the medial to lateral zones.…”

A characteristic MRI finding to diagnose a partial tear of the medial meniscus posterior root: an ocarina sign

“…Several characteristic MRI findings have been reported to detect MMPRT. In coronal images, giraffe neck sign and cleft/truncation sign (vertical linear defect) are useful to diagnose MMPRT [ 4 – 8 ]. In sagittal images, a ghost (or white meniscus) sign that shows a disappearance of the MM posterior root/horn on some slices can diagnose MMPRT with high sensitivity.…”