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Am J Sports Med 2021 Jun 30;49(7):1822-1826. Epub 2021 Apr 30.

Department of Orthopaedics, Children's Hospital, CHU de Toulouse, Toulouse, France.

Background: Anterior cruciate ligament (ACL) tears represent 13% of knee injuries in children. Medial meniscal tears are commonly associated with ACL ruptures. Ramp lesions correspond to posterior meniscocapsular tears of the medial meniscus. Read More

ANZ J Surg 2021 Jun 27;91(6):1284-1289. Epub 2021 Apr 27.

Department of Epidemiology, The Canberra Hospital, Canberra, Australian Capital Territory, Australia.

Background: Magnetic resonance imaging (MRI) is commonly used for diagnosis and as a research tool, but its accuracy is questionable. The goal of this study was to compare the accuracy of knee MRI with clinical assessment for diagnosing meniscal tears, and to determine the accuracy of MRI for grading chondral lesions, relative to arthroscopy.

Methods: Physically active patients presenting with mechanical symptoms warranting a knee arthroscopy and satisfying the inclusion criteria, had both a knee arthroscopy and MRI performed. Read More

Arch Orthop Trauma Surg 2021 Apr 28. Epub 2021 Apr 28.

Ganga Hospital, 313, Mettupalayam Road, Coimbatore, 641043, India.

Introduction: Meniscus extrusion in medial meniscus posterior root tears (MMPRT) is a consistent MRI finding and correction of extrusion is a primary objective of the meniscal root repair. The purpose of the study is to evaluate feasibility of correction of extrusion and correlation of various factors affecting the postoperative extrusion correction and outcomes in all degenerative medial meniscus posterior roots (MMPRTs).

Methods: A retrospective study of patients who presented with degenerative MMPRTs following trivial incident (Jun 2014 and Aug 2018) and included isolated Laprade type 2 root tear with extrusion in MRI. Read More

Arthroscopy 2021 05;37(5):1378-1380

Twin Cities Orthopedics, Edina-Crosstown. Edina, Minnesota, U.S.A.. Electronic address:

Patients with multiligament knee injuries require a thorough examination (Lachman, posterior-drawer, varus, valgus, and rotational testing). Diagnoses are confirmed with magnetic resonance imaging as well as stress radiographs (posterior, varus, and valgus) when indicated. Multiple systematic reviews have reported that early (<3 weeks after injury) single-stage surgery and early knee motion improves patient-reported outcomes. Read More

Osteoarthritis Cartilage 2021 Apr 18. Epub 2021 Apr 18.

University of California San Diego, San Diego, CA, United States. Electronic address:

Objective: Meniscal degeneration is strongly associated with osteoarthritis (OA). We aimed to evaluate a 3D ultrashort-echo-time Cones magnetization transfer (UTE-Cones-MT) sequence for quantification of macromolecular fraction (MMF) and MT ratio (MTR) in menisci of healthy volunteers and patients with different degrees of OA.

Methods: Patients with mild OA (n = 19; 37-86 years; 10 males) or advanced OA (n = 12; 52-88 years; 4 males) and healthy volunteers (n = 17; 20-49 years; 7 males) were scanned with T2-FSE and UTE-Cones-MT sequences at 3T. Read More

Am J Sports Med 2021 Jun 21;49(7):1813-1821. Epub 2021 Apr 21.

Hôpital Privé Jean Mermoz, Ramsay Générale de Santé, Centre Orthopédique Santy, FIFA Medical Centre of Excellence, Lyon, France.

Background: Ramp lesions are defined as a particular type of injury within the posterior horn of the medial meniscus and its meniscocapsular attachments. Five subtypes have been described: type 1, meniscocapsular lesion; type 2, partial superior lesion; type 3, partial inferior lesion or hidden type; type 4, complete tear in the red zone; and type 5, complete double tear.

Purpose: (1) To determine the prevalence of different subtypes of ramp lesions in patients undergoing arthroscopic anterior cruciate ligament reconstruction (ACLR). Read More

Skeletal Radiol 2021 Apr 17. Epub 2021 Apr 17.

Department of Radiology and Imaging Sciences Section of Musculoskeletal Imaging, Emory University Hospital, 59 Executive Park South, 4th Floor Suite 4009, Atlanta, GA, 30329, USA.

Objective: To assess the relationship between low- and high-grade subchondral insufficiency fracture of the knee (SIFK) and meniscal tear/type/location, severity of meniscal extrusion, grade of chondrosis, and extent of surrounding edema-like marrow signal intensity.

Materials And Methods: Our retrospective study included 219 patients with knee pain and SIFK seen on MRI. SIFK lesions were categorized from grade 1 to 4 with a low grade (1 and 2) vs high grade (3 and 4) distinction. Read More

Knee Surg Sports Traumatol Arthrosc 2021 Apr 9. Epub 2021 Apr 9.

Department of Orthopedic Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No.1665 Kongjiang Road, Shanghai, People's Republic of China.

Purpose: To describe a non-anatomic arthroscopic all-inside repair technique for middle-aged and older patients with medial meniscus posterior root tears (MMPRTs) and to evaluate the short- to mid-term clinical and radiologic results. The hypothesis was that this procedure would yield good clinical outcome results and structural healing in middle- and older-aged patients.

Methods: This was a retrospective study evaluating patients who had undergone MMPRT repair by suturing the meniscal root directly to the capsule, rather than by the transtibial technique, between 2013 and 2016. Read More

Ochsner J 2021 ;21(1):115-118

The University of Queensland Faculty of Medicine, Ochsner Clinical School, New Orleans, LA.

Discoid medial meniscus is an extremely rare congenital anatomic variant with an estimated incidence of 0.12%. Arthroscopic meniscal saucerization and repair are reserved for symptomatic tears only. Read More

Int J Surg Case Rep 2021 Apr 17;81:105757. Epub 2021 Mar 17.

Department of Orthopedics, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, No. 16766, Jingshi Road, Jinan, Shandong Province, 250014, China.

Introduction: We report a relatively rare case of partial-thickness radial tear in the inferior surface of lateral meniscus, while the superior surface is intact. This situation was similar to PASTA rotator cuff tear. Meanwhile, there is a full-thickness radial tear in the edge. Read More

Orthop J Sports Med 2021 Mar 17;9(3):2325967121989678. Epub 2021 Mar 17.

Sports Medicine Service, Beijing Jishuitan Hospital, Beijing, China.

Background: Clinical outcomes of surgical repairs for tears of the lateral meniscus posterior root (LMPR) in patients undergoing anterior cruciate ligament (ACL) reconstruction (ACLR) have not been comprehensively investigated.

Purpose: To systematically review the clinical, radiographic, and arthroscopic results of surgical repairs for tears of the LMPR in patients undergoing ACLR.

Study Design: Systematic review; Level of evidence, 4. Read More

BMC Musculoskelet Disord 2021 Apr 2;22(1):322. Epub 2021 Apr 2.

Guangzhou University of Chinese Medicine, 12 Airport Road, Guangzhou, 510405, Guangdong Province, China.

Background: Recent studies have pointed out that arthroscopy, the commonly-used surgical procedure for meniscal tears, may lead to an elevated risk of knee osteoarthritis (KOA). The biomechanical factors of KOA can be clarified by the biomechanical analysis after arthroscopic partial meniscectomy (APM). This study aimed to elucidate the cartilage stress and meniscus displacement of the tibiofemoral joint under flexion and rotation loads after APM. Read More

Knee 2021 Mar 26;29:557-563. Epub 2021 Mar 26.

Warwick Clinical Trials Unit, Clinical Sciences and Research Laboratory, University Hospital Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, United Kingdom. Electronic address:

Background: Magnetic resonance imaging (MRI) is one of the most widely used investigations for knee pain as it provides detailed assessment of the bone and soft tissues. The aim of this study is to report the frequency of each diagnosis identified on MRI scans of the knee and explore the relationship between MRI results and onward treatment.

Methods: Consecutive MRI reports from a large NHS trust performed in 2017 were included in this study. Read More

Arthroscopy 2021 Mar 25. Epub 2021 Mar 25.

Department of Orthopedic Surgery and Sports Medicine, Mayo Clinic, Rochester, Minnesota, U.S.A.. Electronic address:

Purpose: To evaluate both the potential causes and resultant outcomes in patients in whom subchondral insufficiency fracture of the knee (SIFK) develops after arthroscopy.

Methods: We performed a retrospective review of all patients with a magnetic resonance imaging diagnosis of SIFK after arthroscopic meniscectomy and chondroplasty over a 12-year period.

Results: A total of 28 patients were included, with a mean age of 61 years and mean follow-up period of 5. Read More

Knee Surg Sports Traumatol Arthrosc 2021 Mar 27. Epub 2021 Mar 27.

Faculty of Medicine, Research Centre for Movement Sciences, The University of Iceland, Sæmundargata 2, 102, Reykjavík, Iceland.

Purpose: Anterior cruciate ligament (ACL) tears have a major impact on the individual and society. Long term effects may be mediated by injuries that occur concurrently to the ACL tear. The purpose of this study was to describe in a nationwide cohort the traumatic meniscal injuries and bone marrow lesions concomitant to ACL tears, their age and sex distribution and the rate any association with ACL reconstruction. Read More

Knee Surg Sports Traumatol Arthrosc 2021 Mar 17. Epub 2021 Mar 17.

Department of Orthopedic Surgery and Sports Center, Myong-Ji Hospital, 55, Hwasu-ro 14 beon-gil, Deogyang-gu, Goyang-si, Seoul, 10475, Gyeonggi-do, Korea.

Purpose: No studies have been conducted to determine long-term predictors of clinical failure after surgical root repair. This study identified long-term prognostic factors of clinical failure after pull-out repair of medial meniscus posterior root tears (MMPRTs) at a minimum of 10 year follow-up.

Methods: A total of 37 patients who underwent MMPRT pull-out repair and had been observed for more than 10 years were recruited for this study. Read More

Open Access J Sports Med 2021 8;12:23-32. Epub 2021 Mar 8.

Department of Radiology, Boston University School of Medicine, Boston, MA, USA.

Purpose: Describe the frequency and severity of knee ligament sprains diagnosed by MRI in athletes participating at the 2016 Summer Olympic Games, their association with certain sports and assess correlations with additional knee structural injury.

Patients And Methods: All knee MRIs performed in the Olympic Village and polyclinics during the 2016 Olympics were retrospectively, blindly reviewed for ligament sprains and associated knee injuries. In addition to the absence or presence of these abnormalities, athletes were stratified by age, gender and sport. Read More

Am J Sports Med 2021 04 15;49(5):1262-1269. Epub 2021 Mar 15.

OrthoSport Victoria, Richmond, Australia.

Background: Biomechanical studies have suggested that the Kaplan fibers (KFs) of the iliotibial band play a role in controlling anterolateral rotation of the knee. There is a paucity of clinical information on whether injury to the KF in the setting of anterior cruciate ligament (ACL) rupture contributes to increased rotatory laxity of the knee.

Purpose/hypothesis: The purpose was to evaluate the association among radiological evidence of KF injury, intraoperative arthroscopic findings, and grade of pivot shift at the time of ACL reconstruction (ACLR). Read More

J Clin Orthop Trauma 2021 May 25;16:264-268. Epub 2021 Feb 25.

Sowjanya Hospitals, 29-23-23, Tadepalli vari street, Suryaraopeta, Vijayawada, Andhra Pradesh, 520002, India.

Ramp lesions are important injuries that are difficult to detect on MRI and pose a challenge to diagnose on arthroscopy since they require inspection of the posteromedial compartment. No bony injury has been reported in the literature as an associated injury with the ramp lesion. We report a rare case of complete ramp tear of the posterior capsule-meniscal junction associated with fracture of the rim of the posterior medial tibial plateau and a double injury to the posterior medial meniscus forming a terrible triad with poor prognosis. Read More

Phys Med 2021 Mar 11;83:64-71. Epub 2021 Mar 11.

Incepto Medical, 128 rue La Boétie, Paris, France.

Purpose: Evaluation of a deep learning approach for the detection of meniscal tears and their characterization (presence/absence of migrated meniscal fragment).

Methods: A large annotated adult knee MRI database was built combining medical expertise of radiologists and data scientists' tools. Coronal and sagittal proton density fat suppressed-weighted images of 11,353 knee MRI examinations (10,401 individual patients) paired with their standardized structured reports were retrospectively collected. Read More

Rheumatology (Oxford) 2021 Mar 10. Epub 2021 Mar 10.

Dept. of General Practice, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands.

Objectives: To identify variables associated with longitudinal change in meniscal extrusion, which might be used as possible targets for knee osteoarthritis (KOA) prevention.

Methods: In a high-risk population of middle-aged overweight women, meniscal extrusion was assessed with magnetic resonance imaging (1.5 T, coronal proton density, in-plane resolution 0. Read More

Clin Imaging 2021 Feb 23;77:158-168. Epub 2021 Feb 23.

Grupo de Joelho, Instituto de Ortopedia e Traumatologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.

Medial meniscus posterior root tears (MMPRT) can lead to meniscal extrusion, loss of hoop tension, loss of load-sharing ability and increased contact pressure. Currently, the most commonly used technique for root repair is arthroscopic transtibial pullout repair (ATPR). This article aims to illustrate both normal and abnormal postoperative imaging findings of the MMPRT repair performed with ATPR, with emphasis on MRI. Read More

Asia Pac J Sports Med Arthrosc Rehabil Technol 2021 Apr 13;24:23-28. Epub 2021 Feb 13.

Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan.

Background: Medial meniscus (MM) tears are associated with both acute and chronic anterior cruciate ligament (ACL) insufficiency and can lead to degenerative changes in the knee. ACL reconstruction (ACLR) combined with the meniscal repair was reported to result in decreased anterior knee joint laxity with evidence of improved patient-reported outcomes in the long term. However, a subtle tear of the MM posterior segment, also known as a ramp lesion, is difficult to detect on conventional magnetic resonance imaging (MRI) and is frequently missed in ACL-deficient knees. Read More

Acad Radiol 2021 Mar 2. Epub 2021 Mar 2.

Department of Traumatology, Clínica Molinón, Gijón, Asturias. Spain.

Meniscal ramp lesions are a special type of injury that affects the periphery of the posterior horn of the medial meniscus (PHMM) and/or its meniscocapsular attachments. They are strongly associated with acute and chronic anterior cruciate ligament (ACL) tears. These lesions have gained much prominence in recent years, due to a significant increase in their diagnosis and their important biomechanical involvement in the knee. Read More

Iowa Orthop J 2020 ;40(2):30-36

Department of Radiology, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, Iowa, USA.

Background: Meniscal tears, specifically lateral meniscal tears, have a larger than expected un-derdiagnosis rate in the presence of an ACL tear. The purpose of our study was to search for an MRI bone contusion pattern associated with MRI occult meniscal tears in patients with an ACL tear, specifically a contusion of the rim of the medial femoral condyle (RMFC). Our hypothesis was that there would be a significant association between RMFC contusions and MRI occult meniscal tears in patients with an ACL tear. Read More

Acad Radiol 2021 Feb 11. Epub 2021 Feb 11.

Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.

Rationale And Objectives: Train and apply natural language processing (NLP) algorithms for automated radiology-arthroscopy correlation of meniscal tears.

Materials And Methods: In this retrospective single-institution study, we trained supervised machine learning models (logistic regression, support vector machine, and random forest) to detect medial or lateral meniscus tears on free-text MRI reports. We trained and evaluated model performances with cross-validation using 3593 manually annotated knee MRI reports. Read More

Cureus 2021 Feb 5;13(2):e13160. Epub 2021 Feb 5.

Department of Orthopaedics, Midlands Regional Hospital Tullamore, Tullamore, IRL.

Introduction Patients with inflammatory arthropathies present a significant challenge to the arthroplasty surgeon when they present with symptomatic degenerative changes of their knee joint. Debate is ongoing regarding the selection of implants for this cohort of patients. There is conflicting evidence for the use of posterior-stabilising (PS) over cruciate-retaining (CR) designs in this cohort. Read More

Emerg Radiol 2021 Feb 10. Epub 2021 Feb 10.

E.B. Singleton Department of Radiology, Texas Children's Hospital, 6701 Fannin Street, Suite 470, Houston, TX, 77030-2399, USA.

Purpose: To describe the first "arcuate sign" case series in the pediatric population, radiologic features of the associated injuries, management, and how they compare with the adult population.

Methods: Retrospective study included patients under 18 years of age with a classic "arcuate sign" on radiographs. Data collected included patient demographics, mechanism of injury, and management. Read More

Am J Sports Med 2021 Feb 10:363546520986817. Epub 2021 Feb 10.

Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA.

Background: Failure to appropriately identify and repair medial meniscal ramp lesions at the time of anterior cruciate ligament (ACL) reconstruction (ACLR) may result in increased anterior tibial translation and internal rotation, increasing the risk for graft failure. Knowledge of the risk factors leading to the development of ramp lesions may enhance clinicians' vigilance in specific ACL-deficient populations and subsequently repair of these lesions at the time of ACLR.

Purpose: To perform a systematic review and meta-analysis of factors tested for associations with ramp lesions and to determine which were significantly associated with the presence of ramp lesions. Read More

J Clin Med 2021 Feb 3;10(4). Epub 2021 Feb 3.

Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul 13620, Korea.

Meniscal tear is a common reason for patients to undergo knee operation, and the medial meniscus posterior root tear (MMPRT) is one of the most frequent kinds of meniscal tears. The purpose of this study was to analyze participants' factors (anthropometric and medical) to the fate of the MMPRT based on the treatment strategy. The hypothesis of this study was that treatment modalities from conservative treatment to final arthroplasty would be affected by participants' affecting factors. Read More