Arthroscopy: The Journal of Arthroscopic & Related Surgery
Original ArticlePredictive Value of Painful Popping for a Posterior Root Tear of the Medial Meniscus in Middle-Aged to Older Asian Patients
Section snippets
Methods
After obtaining approval from our institutional review board, we conducted a retrospective review of medical records of patients who underwent arthroscopic sur-geries for medial meniscus tears at our institution between January 2000 and December 2010. The inclusion criteria were (1) an isolated medial meniscus tear with or without a cartilage lesion and (2) no significant sports injuries or traumatic events other than daily activities. All subjects had MRI preoperatively and were diagnosed with
Results
We identified 936 patients with an isolated medial meniscus tear who met the inclusion criteria. There were 332 men and 604 women with a mean age of 41 years (range, 25 to 66 years). Types of medial meniscus tears are shown in Table 1. Among all 936 patients, 237 (25.3%) were diagnosed with an isolated MMPRT (Fig 3). Acute onset with a single event of a painful popping sensation was present in 9.1% (86) of these 936 medial meniscus tears. Patients recalled a single event of a painful popping
Discussion
An MMPRT is not uncommon in the middle-aged to older Asian population, potentially because of lifestyle and activity level.4, 18 In our study the presence of a single event of a painful popping sensation was 9.1% (86 of 936 patients) for all kinds of medial meniscus tears. However, the positive predictive value of a single event of a painful popping sensation for an isolated MMPRT was very high (96.5%). When a middle-aged to older Asian patient presents with intense knee pain after a single
Conclusions
A single event of painful popping can be a highly predictive clinical sign of an MMPRT in the middle-aged to older Asian population. However, it has low sensitivity for the detection of an MMPRT.
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Cited by (42)
Semi-quantitative arthroscopic scoring system is related to clinical outcomes in patients after medial meniscus posterior root repair
2022, Journal of Orthopaedic ScienceCitation Excerpt :In addition, patients with semi-quantitative scores ≥8 points had better clinical outcomes than those <8 points, whereas no significant difference was found in complete healing and lax healing using qualitative arthroscopic evaluation. MMPRT is prone to occur when the patients are descending, exercising, or twisting the knee joint [14]. Severe knee varus is also a risk factor for MMPRT to increase the contact pressure on the medial compartment of the knee joint and accelerate the progression of OA, which is predictive for a clinical failure after MMPRT [15].
A spreading roots sign: Characteristic sign of the preliminary stage of medial meniscus posterior root tear on magnetic resonance imaging
2022, Journal of Orthopaedic ScienceTranstibial pullout repair of medial meniscus posterior root tear restores physiological rotation of the tibia in the knee-flexed position
2019, Orthopaedics and Traumatology: Surgery and ResearchCitation Excerpt :Patients with decreased meniscus extrusion at 1 year postoperatively had more favorable clinical scores and radiographic findings at midterm follow-up than did those with increased extrusion [10]. Therefore, prompt diagnosis of MMPRT on the basis of clinical signs [11] or a single painful popping event is necessary [12], and MMPRT repair is recommended to prevent subsequent cartilage degeneration or meniscus extrusion [13]. A robotic arm study reported that tibial external rotation is increased in association with MMPRT, and rotation is restored by posterior root repair [14].
Injury patterns of medial meniscus posterior root tears
2019, Orthopaedics and Traumatology: Surgery and Research
The authors report the following source of funding in relation to this article: Supported by a 2013 Inje University research grant.