Performed at one institution, Observational, Retrospective, Tissue characterisation, Grafts, Athletic injuries, Surgery, Complications, MR, CT, Musculoskeletal system, Musculoskeletal soft tissue, Musculoskeletal
M. Martínez Mora1, E. Llopis San Juan2, E. fernandez garcia1, J. Solaz Solaz1, E. Belloch1, V. higueras guerrero1, R. Mut Pons1; 1alzira/ES, 2Alzira-Valencia/ES
The menisci are semilunar fibrocartilaginous structures positioned between the femoral condyles and the tibial plateau which play an important role in the knee joint, including force transmission, shock absorption, lubrication, and stability. (Fig.2,3).
Meniscal tears are by far the most common knee injuries, and MRI is the non-invasive technique of choice to diagnose this pathology. (Fig.4,5,6A). Radiologists should keep pitfalls of meniscal tears in mind to make an accurate diagnosis. (Fig.7,8,9).
For treatment planning it is essential to describe the different meniscal tears using the ISAKOS classification of meniscal tears, which provides a standardized system, allowing surgical planning and giving prognosis. This system includes seven categories. (Fig.10). Regarding tear pattern, we can find:
- Horizontal tear and horizontal flap. (Fig.11,12).
- Longitudinal-vertical tear and bucket-handle tear. (Fig.13,14, 15).
- Radial tear and vertical flap. (Fig.16,17,18).
- Complex tear. (Fig.19,20).
Other radiological descriptions not included in the ISAKOS classification are described. (Fig.21,22).
In the past, meniscectomy was the standard surgery for meniscal tears because the meniscus was considered a functionless remnant vestige, but later different studies showed that meniscectomy leads to early osteoarthritis. Therefore in the last decades efforts have been made to repair/replace the meniscus.
Interpretation of MRI findings is a challenge after any type of meniscal surgery. Direct CT-MR arthrography are currently used as additional tools to make an accurate diagnosis. (Fig.6B).