Journal of Clinical Orthopaedics | Vol 5 | Issue 2 |  July-Dec 2020 | page:41-44 | Rajkumar S Amaravathi

Author: Rajkumar S Amaravathi [1]

[1] Department of Arthroscopy and Sports Injury,St John’s Medical College, Bangalore 560034, Karnataka

Address of Correspondence
Dr. Rajkumar S Amaravathi,
Professor Orthopedics,
Head Division of Arthroscopy and Sports Injury,St John’s Medical College, Bangalore 560034, Karnataka
E-mail: rajamarvathi@gmail.com

Abstract

The meniscus provides shock absorption and stability by generating circumferential stresses as load bearing occurs. This is because of the root attachments of the meniscus to the tibia, preventing meniscus extrusion and a subsequent alteration of the transmitted hoop .Meniscus root tears lead to an increase of peak tibiofemoral contact pressure and tibiofemoral contact area which has been shown to lead to altered biomechanics and an acceleration of degenerative changes of the knee. The treatment method for meniscus injuries now primarily is preservation and anatomic restoration, because non-operative and meniscectomy treatments are associated with poor clinical outcomes and progression to degenerative changes in the joint.
Keywords: Meniscus Root Injury.

References

1. Hwang BY, Kim SJ, Lee SW, Lee HE, Lee CK, Hunter DJ, Jung KA. Risk factors for medial meniscus posterior root tear. Am J Sports Med. 2012 Jul;40(7):1606-10. doi: 10.1177/0363546512447792. Pub 2012 May 11. PMID: 22582224.
2. De Smet AA, Blankenbaker DG, Kijowski R, Graf BK, Shinki K. MR diagnosis of posterior root tears of the lateral meniscus using arthroscopy as the reference standard. AJR Am J Roentgenol. 2009 Feb;192(2):480-6. doi: 10.2214/AJR.08.1300. PMID: 19155414.
3. Pache S, Aman ZS, Kennedy M, Nakama GY, Moatshe G, Ziegler C, LaPrade RF. Meniscal Root Tears: Current Concepts Review. Arch Bone Jt Surg. 2018 Jul;6(4):250-259. PMID: 30175171; PMCID: PMC6110430.
4. Allaire R, Muriuki M, Gilbertson L, Harner CD. Biomechanical consequences of a tear of the posterior root of the medial meniscus. Similar to total meniscectomy. J Bone Joint Surg Am. 2008 Sep;90(9):1922-31. doi: 10.2106/JBJS.G.00748. PMID: 18762653.
5. Frank JM, Moatshe G, Brady AW, Dornan GJ, Coggins A, Muckenhirn KJ, Slette EL, Mikula JD, LaPrade RF. Lateral Meniscus Posterior Root and Meniscofemoral Ligaments as Stabilizing Structures in the ACL-Deficient Knee: A Biomechanical Study. Orthop J Sports Med. 2017 Jun 15;5(6):2325967117695756. doi: 10.1177/2325967117695756. PMID: 28660229; PMCID: PMC5476330.
6. LaPrade CM, Foad A, Smith SD, Turnbull TL, Dornan GJ, Engebretsen L, Wijdicks CA, LaPrade RF. Biomechanical consequences of a nonanatomic posterior medial meniscal root repair. Am J Sports Med. 2015 Apr;43(4):912-20. doi: 10.1177/0363546514566191. Epub 2015 Jan 26. PMID: 25622987.
7. Cerminara AJ, LaPrade CM, Smith SD, Ellman MB, Wijdicks CA, LaPrade RF. Biomechanical evaluation of a transtibial pull-out meniscal root repair: challenging the bungee effect. Am J Sports Med. 2014 Dec;42(12):2988-95. doi: 10.1177/0363546514549447. Epub 2014 Sep 19. PMID: 25239930.
8. Kim JH, Chung JH, Lee DH, Lee YS, Kim JR, Ryu KJ. Arthroscopic suture anchor repair versus pull-out suture repair in posterior root tear of the medial meniscus: a prospective comparison study. Arthroscopy. 2011 Dec;27(12):1644-53. doi: 10.1016/j.arthro.2011.06.033. Epub 2011 Oct 7. PMID: 21982389.
9. Antao NA. Patterns of avulsions of posterior horn of medial meniscus. IJO 2000, VOL34(4);284-87.
10. LaPrade CM, James EW, Cram TR, Feagin JA, Engebretsen L, LaPrade RF. Meniscal root tears: a classification system based on tear morphology. Am J Sports Med. 2015;43(2):363-369. doi:10.1177/0363546514559684
11. Forkel P, Foehr P, Meyer JC, Herbst E, Petersen W, Brucker PU, Burgkart R, Imhoff AB. Biomechanical and viscoelastic properties of different posterior meniscal root fixation techniques. Knee Surg Sports Traumatol Arthrosc. 2017 Feb;25(2):403-410. doi: 10.1007/s00167-016-4237-4. Epub 2016 Jul 11. PMID: 27401006.
12. Brody JM, Lin HM, Hulstyn MJ, Tung GA. Lateral meniscus root tear and meniscus extrusion with anterior cruciate ligament tear. Radiology. 2006 Jun;239(3):805-10. doi: 10.1148/radiol.2393050559. PMID: 16714462.
13. Ozkoc G, Circi E, Gonc U, Irgit K, Pourbagher A, Tandogan RN. Radial tears in the root of the posterior horn of the medial meniscus. Knee Surg Sports Traumatol Arthrosc. 2008 Sep;16(9):849-54. doi: 10.1007/s00167-008-0569-z. Epub 2008 Jun 7. PMID: 18536902.
14. Koo JH, Choi SH, Lee SA, Wang JH. Comparison of Medial and Lateral Meniscus Root Tears. PLoS One. 2015 Oct 21;10(10): e0141021. doi: 10.1371/journal.pone.0141021. PMID: 26488288; PMCID: PMC4619510.
15. Lee SS, Ahn JH, Kim JH, Kyung BS, Wang JH. Evaluation of Healing After Medial Meniscal Root Repair Using Second-Look Arthroscopy, Clinical, and Radiological Criteria. Am J Sports Med. 2018 Sep;46(11):2661-2668. doi: 10.1177/0363546518788064. Epub 2018 Aug 17. PMID: 30118319.
16. Steineman BD, LaPrade RF, Santangelo KS, Warner BT, Goodrich LR, Haut Donahue TL. Early Osteoarthritis After Untreated Anterior Meniscal Root Tears: An in Vivo Animal Study. Orthop J Sports Med. 2017 Apr 27;5(4):2325967117702452. doi: 10.1177/2325967117702452. PMID: 28508006; PMCID: PMC5415046.
17. Rajkumar S. Amaravathi, Anoop Pilar, Sandesh G. Manohar, Madan Mohan Muniswamy, Fazal R. Rehman, Naveen J. Mathai . Arthroscopic management of neglected complex knee injury. Int J Res Orthop; Nov 2020(6):1327-1331. DOI: 10.18203/issn.2455-4510.IntJResOrthop20204607
18. Kim YM, Joo YB, Lee WY, Kim YK. Remodified Mason-Allen suture technique concomitant with high tibial osteotomy for medial meniscus posterior root tears improved the healing of the repaired root and suppressed osteoarthritis progression. Knee Surg Sports Traumatol Arthrosc. 2020 Jul 25. doi: 10.1007/s00167-020-06151-w. Epub ahead of print. PMID: 32712682.
19. Ke X, Qiu J, Chen S, Sun X, Wu F, Yang G, Zhang L. Concurrent arthroscopic meniscal repair during open-wedge high tibial osteotomy is not clinically beneficial for medial meniscus posterior root tears. Knee Surg Sports Traumatol Arthrosc. 2020 May 10. doi: 10.1007/s00167-020-06055-9. Epub ahead of print. PMID: 32390120.

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