Learning objectives
Review relevant meniscal anatomy based on Magnetic Resonance Imaging (MRI).
Identify and demonstrate the main imaging findings of a posterior medial meniscal root tear (PMMRT) with illustrative cases.
Discuss PMMRT association with several pathologies and clarify possible pitfalls.
Elaborate a diagnostic work-up protocol for the radiologist
Background
Identification of meniscal root tears at MRI is crucial because new arthroscopic surgical techniques have been developed to repair meniscal root tears and preserve the tibiofemoral cartilage of the knee.
If left untreated,
the consequences may include an early degenerative joint disease,
with features like progressive cartilage loss,
osteoarthritis,
and subchondral edema,
with the potential for development of a subchondral insuffciency fracture.
MRI consists in a fundamental tool in the anatomic assessment,
detection and management of PMMRT.
We will review this condition,
focusing on the...
Findings and procedure details
The meniscal roots are ligament-like structures that anchor the meniscal body and horns to the tibial plateau and provide added mechanical stability for femorotibial gliding [1,3]
The semicircular medial meniscus has a wide posterior horn,
narrows anteriorly,
and has a more open C-shaped configuration than the more circular lateral meniscus. The attachment of the
posterior horn of the medial meniscus is located at the posterior intercondylar fossa of the tibia.
It can be identified between the attachment of the posterior horn of the lateral meniscus...
Conclusion
Meniscal root tears lead to altered biomechanics and progressive osteoarthritis of the knee.
Posterior meniscal root tears represent an often overlooked pathology.
We believe that a detailed description of PMMRL pathology would be helpful for orthopedic surgeons to manage PMMRL tears in clinical practice.
With a greater understanding of the importance of meniscal root injuries,
more emphasis has been placed recently on the development of surgical techniques to repair meniscal root tears,
to prevent long-term sequelae.
References
Brody JM,
Hulstyn MJ,
Fleming BC,
Tung GA: The meniscal roots: gross anatomic correlation with 3-T MRI findings.
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SAKAMOTO,
Flávia Aiko et al.Raízes meniscais: anatomia e avaliação por meio da ressonância magnética.Rev.
Bras.
Reumatol.[online].
2007,
vol.47,
n.5 [cited 2018-01-12],
pp.370-375.
Posterior Root Meniscal Tears: Preoperative,
Intraoperative,
and Postoperative Imaging for Transtibial Pullout Repair.
Andrew R.
et al.
RadioGraphics201636:6,1792-180
MR Imaging–based Diagnosis and Classifcation of Meniscal Tears.
Jie C.
et al.
RadioGraphics201434:4,981-999
Gilbert Moatshe,
Jorge Chahla,
Erik Slette,
Lars Engebretsen & Robert...