Altered signal intensity in the posterior horn of the medial meniscus: An MR finding of questionable significance (original) (raw)
Related papers
2011
Author comment and action: Thank you for giving us the opportunity to submit a revised version of the above manuscript. We apologize for the delay, but based on the reviewer comments, new readings had to be made, which delayed completion of the revision. We recommend that you copyedit the paper to improve the style of written English. Author comment and action: We have carefully proofread the paper and asked a native speaker to double check the wording. We hope you find it improved. We would be grateful if you could address the comments in a revised manuscript and provide a cover letter giving a point-by-point response to the concerns. Author comment and action: Please find our itemized response to each reviewer concern below. Please also highlight (with 'tracked changes'/coloured/underlines/highlighted text) all changes made when revising the manuscript to make it easier for the Editors to give you a prompt decision on your manuscript. Author comment and action: We are submitting the revised manuscript with a track change and in a clean version, so that the changes are visible to the reviewer. Please also ensure that your revised manuscript conforms to the journal style (http://www.biomedcentral.com/info/ifora/medicine\_journals). It is important that your files are correctly formatted. Author comment and action: We have checked the consistency with the formal requirements. Author comment: The primary objective of this study was not to provide "normal" values for persons without any structural knee changes, but to compare meniscus morphometry in a group of men and women, who are "clinically" normal (no pain, no radiographic changes, no risk factors of OA), see title. The fact that they are older may be seen as a weakness, but also is a strength, because it makes the values more directly comparable with those obtained in knees with radiographic OA, who generally are from persons in this age range. The subjects we had chosen were without any clinical or radiographic evidence of OA (and also did not have risk factors). However, we admit that we were not able to make sure they were without MR evidence of OA, and we agree that painless and radiographically normal knees not necessarily are entirely healthy at an MRI structural level (Englund et al. NEJM 2008).
European Journal of Orthopaedic Surgery and Traumatology, 2020
Purpose: Medial meniscus posterior root tears (MMPRTs) can cause severe medial extrusion of the medial meniscus (MMME) and the progression of knee degenerative changes, inducing a high signal intensity of the meniscus on magnetic resonance imaging (MRI). Although MMME and intra-meniscal signal intensity (IMSI) reportedly decreased within 3 months after MMPRT repair, no previous studies have reported these changes after a 1-year follow-up. This study aimed to investigate the 1-year postoperative changes in MMME and IMSI on MRI after using different suture techniques. Methods: Overall, 33 patients with MMPRT were evaluated, 22 underwent FasT-Fix-dependent modified Mason-Allen suture (F-MMA) repair, and 11 underwent two simple stitches (TSS) repair. MRI examinations were performed preoperatively and 1 year postoperatively. MMME and IMSI were determined using MRI. Results: A significant decrease in postoperative MMME was observed in the TSS group (4.1±1.0) relative to that in the F-MMA group (5.1±1.4, P=0.03). A significant decrease in postoperative IMSI (0.75±0.14) was observed relative to preoperative IMSI in the TSS group (P<0.01), whereas postoperative IMSI (0.94±0.25) was similar to preoperative IMSI in the F-MMA group (P=0.06). Furthermore, a significant decrease in postoperative IMSI was observed in the TSS group relative to that in the F-MMA group (P<0.01). Conclusions: The most important finding of this study is that TSS repair yielded a greater decrease in MMME and IMSI than F-MMA repair in patients with MMPRT. These results suggest that TSS repair is more useful for restoring loading stress to the posterior horn of the medial meniscus.
The insertion of the anterior horn of the medial meniscus: an anatomic study
Muscles, ligaments and tendons journal, 2013
The purpose of this study was to identify the various patterns of insertion of the anterior horn of the medial meniscus in Ghanaian subjects. The study involved 35 cadaveric knees (26 males and 9 females). Berlet and Fowler classification was used to classify the insertion of the anterior horn of the medila meniscus. The distribution of the insertion pattern was as follows; 42.9% (15) had type I insertion, 45.7% (16) had type II, type III and IV insertions were each found in 5.7% (2) of the dissected knees. Type II insertion had the highest incidence which was a deviation from what has been reported in literature. The incidence of the anterior intermeniscal ligament (AIML) was 34.3%, which was much lower that most studies have reported. The findings of the study may suggest that the pattern of insertion of the anterior horn of the medial meniscus may be different in the Ghanaian population; further research is needed in this area.
The American Journal of Sports Medicine, 2008
The attachment of the posterior horn of the medial meniscus has been shown to be essential in maintaining normal meniscal positioning and function, as well as preventing extrusion of the medial meniscus. Traumatic avulsion fractures of the posterior horn of the medial meniscus, also referred to as meniscal ossicles, have been previously described in case reports. The literature has suggested that meniscal ossicles could arise from multiple causes, including trauma, 3,12,15 metaplastic ossification, 16 or a sesamoid bone. 5,14 Regardless of cause, there has also been no agreement regarding treatment of these meniscal ossicles. A previous review found that the majority of physicians chose to initially treat these cases conservatively; however, many of the cases went on to require arthrotomy or arthroscopy with meniscectomy because of persistent symptoms. 10 To our knowledge, this is only the second case report describing surgical reattachment of a bony avulsion fracture of the posterior horn root of the medial meniscus. 12
Use of magnetic resonance imaging to determine laterality of meniscal size in healthy volunteers
PLOS ONE, 2020
IntroductionThe menisci are responsible for several functions. They are shock absorbers during dynamic loading on the knee and provide a broader surface area on which to distribute stress evenly to the tibia and femur. These functions allow for smoother movement and greater stability of the knee joint. Meniscal injury can be a great impediment to the function of the knee. Therefore, in the case of meniscal injury, our main concern is the relief of patient symptoms, followed by consequent restoration of meniscal function to the greatest of our ability.To prevent the long terms effects of a meniscectomy, meniscal allograft transplantation (MAT) was developed. The potential of using the size of the contralateral healthy menisci, to determine the size of the menisci to be replaced, will be discussed.MethodsKnee MRIs done on healthy patients in the past 5 years were reviewed. Magnetic Resonance Imaging was performed using a 3-T scanner. Each individual was examined with knee joints in full extension. Measurements were performed two separate times, two weeks apart. A mean of three measurements was made during each session to reduce error.Thirty-eight normal bilateral knee joints MRIs remained (16 males, 22 females). Participants were sampled from the institutional Picture Archiving and Communication System (PACS). Age, gender, and the medial meniscal and lateral meniscal size of both knees were recorded. The laterality of the menisci was compared between both knees in each patient.ResultsA total of 38 patients were included in this study, with a mean age of 37.39 (±9.50) years. They were 16 (42.1%) men and 22 (57.9%) women. We didn’t find any significant difference in the mid-coronal section between left and right knees meniscal measurements. None of the measurements were significantly different between men and women. There was no significant difference in the medial mid-sagittal section or lateral mid-sagittal section between left and right knee meniscal measurements.ConclusionThe results obtained in this study may support the use of MRI of the bilateral knee to obtain an appropriately sized allograft.
Acta Radiologica, 2001
Purpose: Meniscal tears associated with displaced fragments are clinically Key words: Knee, meniscus; tear, significant. We propose the ''disproportional posterior horn sign'' as a support-fragment; arthroscopy; MR imaging. ive criterion to identify a posterocentrally displaced meniscal fragment on MR imaging studies. If the meniscal posterior horn in the central portion appears Correspondence: Tiffany Ting-Fang larger than that in the peripheral section, it is considered positive for ''dispro-Shih, Department of Medical portional posterior horn sign''. Imaging, National Taiwan Material and Methods: MR images obtained in 42 patients with 43 lesions, University, Medical College and confirmed to have displaced meniscal tears, were included in this study. The MR Hospital, No. 7, images were retrospectively evaluated for the presence of the ''disproportional Chung-Shan S. Road, Taipei, posterior horn sign'', as well as the other known signs. Taiwan. Results: The ''disproportional posterior horn sign'' was seen in 9 (20.9%) of FAX π886 2 27548108. 43 lesions, including 1 lateral discoid meniscal tear, 5 lateral meniscal tears and 3 medial meniscal tears. Five of them also had other signs of a displaced menis-Accepted for publication 25 January cal fragment. However, the remaining 4 cases only exhibited the ''dispro-2001. portional posterior horn sign''. For the other MR signs, the ''absent bow tie sign'' was detected in 40 (93%) of 43 lesions, the ''flipped meniscus sign'' in 27 (62.8%) of 43 lesions, the ''double posterior cruciate ligament sign'' in 17 (39.5%) of 43 lesions and the ''notch fragment sign'' in 22 (51.2%) of 43 lesions. Conclusion: The ''disproportional posterior horn sign'' is helpful in demonstrating a posterocentrally displaced meniscal fragment, especially when other characteristic signs are unremarkable or absent.
Medial dislocation of the medial meniscus
Journal of Bone and Joint Surgery - British Volume, 2009
We present the first reported case of symptomatic medial dislocation of the medial meniscus in a patient who had no previous history of trauma and who had an otherwise normal knee. The treatment of instability of the medial meniscus is controversial and studies have indicated that certain individuals without a firm meniscal bony insertion may be predisposed to meniscal dislocation. In our patient, the meniscal instability interfered with daily activities. Operative stabilisation by reconstruction of the meniscotibial ligaments cured the symptoms.