Should the meniscal height be considered for preoperative sizing in meniscal transplantation?

Abstract

Purpose and hypothesisIn preoperative sizing for meniscal transplantation, most authors take into consideration the length and width of the original meniscus, but not its height. This study aimed at evaluating (1) whether the meniscal height is associated with the meniscal length and width, (2) whether the heights of the meniscal segments are associated with the individual’s anthropometric data, (3) whether the heights of the meniscal segments are associated with each other in the same meniscus, and (4) the degree of symmetry of the meniscal dimensions between the right and left knees.MethodsIn this cross-sectional, observational study, two independent radiologists measured the meniscal length, width and height in knee magnetic resonance imaging scans obtained from 25 patients with patello-femoral pain syndrome. Reproducibility of measurements was calculated with intraclass correlation coefficients. Associations between the anthropometric data and the meniscal measurements, the meniscal length and width versus height, and the heights of the meniscal segments in the same meniscus were examined with Pearson’s correlation.ResultsInter-observer reliability was excellent (>0.8) for length and height and good (0.6–0.8) for width measurements. There was also excellent agreement (>0.8) for the length and width of the menisci in the right and left knees. The heights of the horns of the lateral meniscus showed good agreement (0.6–0.8), while the heights of the other meniscal segments had excellent agreement between the sides (>0.8). There were significant associations with generally low (r < 0.5) correlation between the heights of the meniscal segments and the lengths and widths of the menisci, between the meniscal height and anthropometric data, and between the heights of the meniscal segments in the same meniscus. Correlations between anthropometric data and meniscal length and width were generally high (r > 0.7).ConclusionsThere was excellent agreement between the meniscal dimensions of the right and left knees, and a weak association between the meniscal height with the meniscal width and length, between the height of the menisci with anthropometric data and between the heights of the segments in the same meniscus. The height of the meniscal segments may be a new variable in preoperative meniscal measurement.

Use of magnetic resonance imaging to determine laterality of meniscal size in healthy volunteers

“…The p-values for all these measurements were all over 0.05, with a confidence interval of 95%. These results correspond to those found in similar studies [9] [10] [11] [12]. The results obtained in this study support the use of MRI of the contralateral knee to obtain an appropriately sized allograft.…”

Meniscal Injury Does Not Significantly Affect the Dimensions of the Intact Meniscus in the Opposite Compartment of the Knee

“…The AP length was defined as the distance between the most anterior point of the anterior horn and the most posterior point of the posterior horn. 8,12 To determine the ML length, a reference line was drawn to connect the most central point of the anterior and posterior horn insertion points; ML length was defined as the distance from the reference line to the most outer margin. 8,12 The AHPH distance was defined as the distance between the center points of root insertion of the anterior and posterior horns.…”

“…8,12 To determine the ML length, a reference line was drawn to connect the most central point of the anterior and posterior horn insertion points; ML length was defined as the distance from the reference line to the most outer margin. 8,12 The AHPH distance was defined as the distance between the center points of root insertion of the anterior and posterior horns. 17 The respective widths and heights of the anterior and posterior horns of each meniscus were evaluated on sagittal MRI scans and were measured at the most anterior and posterior points of the meniscus (Figure 2).…”

“…17 The respective widths and heights of the anterior and posterior horns of each meniscus were evaluated on sagittal MRI scans and were measured at the most anterior and posterior points of the meniscus (Figure 2). 3,6,12 The width and height of the midbody of each meniscus were evaluated on coronal MRI scans; those of the medial and lateral meniscus were measured at the most medial and lateral points on the meniscus, respectively (Figure 3). 3,6,12 To minimize observation bias, 2 independent investigators (H.S.L., C.H.P.)…”

“…3,6,12 The width and height of the midbody of each meniscus were evaluated on coronal MRI scans; those of the medial and lateral meniscus were measured at the most medial and lateral points on the meniscus, respectively (Figure 3). 3,6,12 To minimize observation bias, 2 independent investigators (H.S.L., C.H.P.) performed all measurements and repeated them after an interval of 2 weeks.…”