Arthroscopy: The Journal of Arthroscopic & Related Surgery
Original ArticleComplex Medial Meniscus Tears Are Associated With a Biconcave Medial Tibial Plateau
Section snippets
Methods
A retrospective review of prospectively collected data from a consecutive series of knees undergoing arthroscopy by a single surgeon (F.A.B.) from July 2014 through August 2015 constituted the study group. The patients were evaluated by the use of preoperative magnetic resonance imaging (MRI; 1.5-Tesla magnets), preoperative standard 4-view radiographs (standing bilateral posteroanterior, standing bilateral notch, true lateral, and bilateral Merchant views), and intraoperative videos. Every
Results
Of the 261 consecutive knee procedures performed for all reasons during the study period, 179 met inclusion criteria for this study. Excluded from this group were 47 ACL reconstructions, 15 fracture fixations, 9 patellar dislocation procedures, 2 previous tibial plateau fractures, 2 Baker cyst excisions, 3 cases of arthrofibrosis requiring release and manipulation, 2 osteochondritis dissecans, and 2 open meniscal cyst excisions. To facilitate analysis, the information was categorized in 2 ways.
Discussion
Biconcave medial tibial plateaus were found in 27.4% in a consecutive series of knee arthroscopies. The biconcave plateau was significantly more likely to have an associated complex medial meniscus tear than those knees without the biconcavity. There was no difference in the frequency of medial meniscus tearing between male and female knees, regardless of the presence or absence of a biconcave tibia. The medial tibial plateau slope was not shown to differ between those knees with and without a
Conclusions
Biconcave medial tibial plateaus were present in 27.4% of a consecutive series of patients undergoing knee arthroscopy. A biconcave medial tibial plateau was associated more frequently with a complex medial meniscus tear.
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Steep posterior slope of the medial tibial plateau is associated with ramp lesions of the medial meniscus and a concomitant anterior cruciate ligament injury
2021, Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilitation and TechnologyCitation Excerpt :Biomechanical studies have shown that a steep MTS leads to increased ATT under load, which may increase the forces acting on the menisci.18,20–24 Furthermore, a complex MM tear was reported to be more frequently associated with a biconcave medial tibial plateau,25 and a shallower MTS and LTS may result in impingement of MM posterior horn and LM anterior horn, respectively.26 Recently, a comprehensive study reported risk factors for ramp lesions in the ACL-deficient knee, which included bone contusion on the posterior medial tibial plateau, chronic injury, steeper medial tibial and meniscal slope, gradual LTS, and varus knee alignment >3°.
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2020, Clinics in Sports MedicineCitation Excerpt :The biconcavity can either be cartilaginous or bony. In a study by Barber and colleagues,51 patients with biconcave medial tibia plateaus had more complex medial meniscus tears (69%) than those without biconcavity (53%). The group with biconcave plateaus had a lower average BMI, making confounding unlikely.
The Epidemiology of Meniscus Injury
2021, Sports Medicine and Arthroscopy ReviewSteep medial tibial slope and prolonged delay to surgery are associated with bilateral medial meniscus posterior root tear
2021, Knee Surgery, Sports Traumatology, ArthroscopySteep posterior slope and shallow concave shape of the medial tibial plateau are risk factors for medial meniscus posterior root tears
2021, Knee Surgery, Sports Traumatology, Arthroscopy
The authors report the following potential conflicts of interest or sources of funding: F.A.B. receives funding from the F. Alan Barber, M.D., F.A.C.S. Research Fund; DePuy-Mitek (payment for lectures including service on speakers bureaus, patents, royalties, payment for development of educational presentations, travel/accommodations/meeting expenses); Linvatec (payment for lectures including service on speakers bureaus, payment for development of educational presentations, and travel/accommodations/meeting expenses); Arthrex (patents); and Johnson and Johnson (stock). M.H.G. receives funding from Smith & Nephew, DePuy Mitek, and DJO (grants) and Wolters Kluwer (royalties).