Ömer Cahit ÇITIR, Osman DEMİR, Orhan BALTA, Eyüp Çağatay ZENGİN, Mehmet Burtaç EREN, Harun ALTINAYAK

Posterior root tear of the medial and lateral meniscus on magnetic resonance imaging of 10,980 knee

It is aimed in this study study to determine the incidence of meniscus root tear in the knee and its effects on additional injuries related to the degree of meniscal extrusion, degree of chondrosis, malalingment and subchondral insufficiency fractures of the knee (SIFK). A total of 277 patients with a meniscal root tear detected on knee magnetic resonance imaging (MRI) taken between January 2011 and December 2020 were retrospectively analyzed. The severity of meniscal extrusion, osteophyte size and alignment were measured on MRI. Subchondral insufficiency fracture medial compartment osteoarthritis, lateral compartment osteoarthritis, additional ligament and meniscal injuries were recorded. The mean medial meniscal extrusion was 4.91 ± 2.2 mm and the mean lateral meniscal extrusion was 3.07 ± 1.56. While the mechanical alignment was 4.05 ± 2.24 degree varus in the patients with medial meniscus root tear, 1.88 ± 3.55 degree valgus in those with lateral meniscus injury. The mean size of tibial osteophyte was 2.51 ± 1.06 mm. In arthrosis grading conducted by using the International Cartilage Repair Society (ICRS) MRI-based grading system, the meniscal extrusion was measured to be 3.09 ± 1.1 mm in grade I, 5.04 ± 2.25 mm in grade II, 5.8 ± 2.01 in grade III and 6.05 ± 1.2 mm in grade 4. A statistically significant relationship was found between meniscal extrusion and age and mechanical alignment (p < 0.001). It was determined that, the patients having high-grade meniscal extrusion suffered from high-grade chondrosis, varus and SIF lesions. It was concluded that meniscus posterior root tear (MPRT) induces meniscal extrusion (MME) leading to subchondral insufficiency fracture of the knee, varus, and gonarthrosis.

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