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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Musculoskeletal Disorders 1/2015

Validity of flounce sign to rule out medial meniscus tear in knee arthroscopy

BMC Musculoskeletal Disorders > Ausgabe 1/2015
Yogendra Gupta, Deepak Prakash Mahara, Arjun Prasad Lamichhane
Wichtige Hinweise

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

Each author has participated actively and sufficiently in this study, and fulfills all authorship criteria of the International Committee of Medical Journal Editors. DPM and APL made substantial contribution in conception of study, analysis and interpretation of data. YG made substantial contribution to conception and design of study, collection of data, analysis, and interpretation of data and drafting of the article. Each author revised critically the manuscript and provided final approval of the version to be published.



The meniscal flounce is wavy fold in free inner border of meniscus seen during knee arthroscopy. The presence of this flounce in medial meniscus has been found to be highly predictive of normal medial meniscus. With meniscus related symptoms being commonest indication for undergoing knee arthroscopy, presence or absence of medial meniscus flounce, can be a good guiding sign. In this study, we aimed to validate the significance of the flounce sign in ruling out medial meniscus tear.


A prospective study was undertaken to validate the significance of flounce sign. There were 62 patients who underwent arthroscopic surgery of the knee over the duration of one and half years. Free inner margin of medial meniscus as seen through anterolateral portal was recorded for the presence or absence of flounce. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of this sign was then calculated for diagnosing normal medial meniscus. Significance was tested with chi square test with 95 % confidence interval.


A total of 62 cases were included. The sensitivity, specificity, PPV, NPV and accuracy of flounce sign was found to be 67.64 %, 92.85 %, 92 %, 70.27 % and 79.03 % respectively, and the result was significant (p value = 0.0001).


The flounce sign has been shown to have high diagnostic value. Use of it in routine knee arthroscopy can be helpful, particularly during screening procedure and in exploring tears which are usually not seen easily through routine portals.
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