Tibial Meniscus Tears
Conditions
Keywords
Menisci, Tibial, Arthroscopy, Magnetic Resonance Imaging
Brief summary
This retrospective observational study aims to investigate whether specific preoperative magnetic resonance imaging (MRI) and radiographic parameters are associated with medial meniscus posterior root tears (MMPRT), and whether these parameters have predictive value for mid-term clinical and radiographic outcomes after arthroscopic repair. Patients with arthroscopically confirmed MMPRT treated between 2020 and 2024 are evaluated based on their preoperative MRI and standing knee radiographs. Imaging parameters of interest include medial tibial slope, meniscal extrusion, tibial plateau depth, posterior root angle, and intercondylar notch morphology. Clinical outcomes are assessed using standardized scoring systems. The study aims to identify imaging-based anatomical risk factors to improve diagnosis, patient selection, and prognosis following MMPRT repair.
Detailed description
This retrospective observational study investigates the role of specific preoperative MRI and radiographic parameters in the diagnosis and prognosis of medial meniscus posterior root tears (MMPRT). Conducted at the Department of Orthopaedics and Traumatology, Karadeniz Technical University Farabi Hospital, the study aims to clarify whether morphologic imaging findings-such as medial tibial slope, meniscal extrusion, tibial plateau depth, posterior root angle, and intercondylar notch morphology-are associated with the presence of MMPRT and influence postoperative outcomes following arthroscopic repair. All imaging measurements were performed using standardized techniques on MRI and radiographs obtained prior to surgery. Parameters were assessed by two independent orthopedic surgeons on separate occasions to evaluate interobserver reliability. A matched control group of patients without meniscal pathology was formed to strengthen the comparative analysis and support the identification of risk factors. By analyzing a wide range of anatomic features on imaging, this study seeks to enhance early diagnostic accuracy, improve patient selection for surgical repair, and refine prognostic counseling. The findings are expected to contribute to the development of objective, imaging-based indicators that can guide clinical decision-making and predict mid-term clinical and radiographic outcomes after MMPRT repair.
Interventions
None listed
Sponsors
Karadeniz Technical University
Study design
Observational model
CASE_CONTROL
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Patients aged 18 years or older Arthroscopically confirmed medial meniscus posterior root tear (MMPRT) diagnosis Availability of preoperative knee MRI and standing long-leg radiographs Minimum 24-month clinical and radiographic follow-up
Exclusion criteria
Lateral meniscus tear Kellgren-Lawrence grade 3 or higher knee osteoarthritis Advanced ligament injuries History of previous knee surgery, osteotomy, or arthroplasty Poor imaging quality Mechanical axis deformities (varus or valgus alignment) Follow-up period less than 24 months
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Medial Tibial Slope | Preoperative MRI assessment | Measured in degrees (°) on sagittal MRI. It is the angle between the tangent to the medial tibial plateau and the anatomical axis of the proximal tibia, drawn using a line connecting the anterior and posterior cortices of the plateau. |
| Medial Meniscus Extrusion | Preoperative MRI assessment | Measured in millimeters (mm) on coronal MRI. Defined as the distance from the outer margin of the medial meniscus to the edge of the tibial plateau |
| Tibial Plateau Depth | Preoperative MRI assessment | Measured in millimeters (mm) on sagittal MRI. It is the perpendicular depth from the deepest point of the medial tibial plateau concavity to a reference line connecting the anterior and posterior cortical rims. |
| Intercondylar Notch Width | Preoperative MRI assessment | Measured in millimeters (mm) on axial MRI images. Width of the intercondylar notch at the level of the popliteal groove. |
| Intercondylar Distance | Preoperative MRI assessment | Measured in millimeters (mm) on axial MRI. The distance between the outer surfaces of the medial and lateral femoral condyles at the level of the intercondylar notch. |
| Medial Femoral Condyle Angle | Preoperative MRI assessment | Measured in degrees (°) on sagittal MRI. It is the angle between the femoral anatomical axis and the curvature of the medial femoral condyle. |
| Notch Width Index (ICNW/ICD Ratio) | Preoperative MRI assessment | A unitless ratio obtained by dividing the intercondylar notch width by the intercondylar distance on axial MRI at the level of the popliteal groove. |
| Notch Shape | Preoperative MRI assessment | Morphological classification based on axial MRI. The intercondylar notch is categorized into A-type, U-type, or W-type based on its geometric configuration. |
| Presence of Osteophyte (Spur) | Preoperative MRI assessment | Binary variable (Yes/No) indicating the presence of an osteophyte at the intercondylar notch on axial or sagittal MRI. |
| Medial Femoral Condyle Width (MFCW) | Preoperative MRI assessment | Measured in millimeters (mm) on coronal MRI. The width of the medial tibial plateau at its maximum span. |
| Medial Tibial Plateau Width (MTPW) | Preoperative MRI assessment | Measured in millimeters (mm) on coronal MRI. The width of the medial tibial plateau at its maximum span. |
| MFCW/MTPW Ratio | Preoperative MRI assessment | Unitless ratio calculated by dividing medial femoral condyle width (MFCW) by medial tibial plateau width (MTPW) on coronal MRI. |
| Medial Femoral Condyle Distal Offset Distance | Preoperative MRI | Measured in millimeters (mm) on sagittal MRI at the level of the medial femoral condyle midpoint (defined on coronal MRI) as the perpendicular distance from the intercondylar axis to the most distal point of the condyle. |
| Medial Femoral Condyle Posterior Offset Distance | Preoperative MRI | Measured in millimeters (mm) on the same sagittal MRI slice as the distal offset, defined as the distance from the intercondylar axis to the most posterior point of the condyle. |
| MFC Distal / Posterior Offset Ratio | Preoperative MRI | A unitless ratio calculated by dividing the medial femoral condyle distal offset distance by its posterior offset distance on sagittal MRI. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| International Knee Documentation Committee (IKDC) Score | Preoperative and minimum 24-month postoperative follow-up | Scored from 0 to 100, this subjective assessment evaluates knee symptoms, function, and ability to engage in sports activities. Higher scores indicate better outcomes. |
| Lysholm Knee Score | Preoperative and minimum 24-month postoperative follow-up | Scored from 0 to 100, this questionnaire evaluates limping, support, locking, pain, swelling, stair climbing, and squatting. Higher scores indicate better knee function. |
| Tegner Activity Scale | Preoperative and minimum 24-month postoperative follow-up | Activity level is rated on a scale from 0 (disability) to 10 (elite sports). Assesses the return to daily or sports-related physical activity. |
| Kellgren-Lawrence Grade Progression | Preoperative and minimum 24-month postoperative radiographs | Graded on a 0-4 scale, this radiographic classification evaluates the severity of osteoarthritis. Progression indicates worsening joint degeneration. |
| Medial Joint Space Width (JSW) | Preoperative and minimum 24-month postoperative radiographs | Measured in millimeters (mm) on standing AP radiographs as the minimum vertical distance between the medial femoral condyle and tibial plateau. Reflects cartilage loss or joint space narrowing. |
Countries
Turkey (Türkiye)
Contacts
PRINCIPAL_INVESTIGATORFevzi Gurkan Aslan, M.D.
Karadeniz Technical University
Outcome results
None listed