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Published in: Skeletal Radiology 8/2020

01-08-2020 | Scientific Article

Association of meniscal flounce in the knee with the pattern and location of meniscal tear, concomitant ligamentous injury, amount of knee joint effusion, and flexion and rotation angles: a magnetic resonance evaluation

Authors: Hyo Jin Kim, Joong Mo Ahn, Youngjune Kim, Yusuhn Kang, Eugene Lee, Joon Woo Lee, Heung-Sik Kang

Published in: Skeletal Radiology | Issue 8/2020

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Abstract

Objective

To determine the association of meniscal flounce with the pattern and location of the meniscal tear, concomitant ligamentous injury, amount of knee joint effusion, and flexion and rotation angles.

Materials and methods

A total of 283 knees of 280 patients were retrospectively reviewed over a 9-month period. Thirty-one magnetic resonance images of patients with meniscal flounce were compared with those of age- and sex-matched control group (n = 62) without meniscal flounce. The presence of meniscal tear was evaluated and, if present, its location and pattern were recorded. The amount of joint effusion was graded, and the joint angle was measured. The Fisher’s exact, Cochran-Armitage trend, and t tests were performed to compare the findings between the two groups. The decision tree analysis was employed to determine the most significant factor of meniscal flounce.

Results

Meniscal flounce was present in 11.0% (31/283) of the adult population. Approximately 80.6% of meniscal flounce occurred in the torn medial menisci. The presence of meniscal flounce was significantly associated with tears at the body (p = 0.007), posterior horn (p = 0.001), and meniscocapsular junction (p = 0.002) of the medial meniscus. The decision tree analysis revealed that the posterior horn tear of the medial meniscus was the most significant predictor of meniscal flounce.

Conclusion

The most significant factor associated with meniscal flounce is tear at the posterior horn of the medial meniscus, followed by tear at the meniscocapsular junction.
Literature
1.
go back to reference Zarins B, McInerney V. Lesions of the meniscus. In: Casscells S, editor. Arthroscopy: diagnostic and surgical practice. Philadelphia: Lea & Febiger; 1984. p. 37–51. Zarins B, McInerney V. Lesions of the meniscus. In: Casscells S, editor. Arthroscopy: diagnostic and surgical practice. Philadelphia: Lea & Febiger; 1984. p. 37–51.
2.
go back to reference Gillquist J, Hagberg G. A new modification of the technique of arthroscopy of the knee joint. Acta Chir Scand. 1976;142(2):123–30.PubMed Gillquist J, Hagberg G. A new modification of the technique of arthroscopy of the knee joint. Acta Chir Scand. 1976;142(2):123–30.PubMed
3.
go back to reference Chew FS. Medial meniscal flounce: demonstration on MR imaging of the knee. AJR Am J Roentgenol. 1990;155(1):199.CrossRef Chew FS. Medial meniscal flounce: demonstration on MR imaging of the knee. AJR Am J Roentgenol. 1990;155(1):199.CrossRef
4.
go back to reference Yu JS, Cosgarea AJ, Kaeding CC, Wilson D. Meniscal flounce MR imaging. Radiology. 1997;203(2):513–5.CrossRef Yu JS, Cosgarea AJ, Kaeding CC, Wilson D. Meniscal flounce MR imaging. Radiology. 1997;203(2):513–5.CrossRef
5.
go back to reference Kim BH, Seol HY, Jung HS, Cha SH, Park CM, Lim HC. Meniscal flounce on MR: correlation with arthroscopic or surgical findings. Yonsei Med J. 2000;41(4):507–11.CrossRef Kim BH, Seol HY, Jung HS, Cha SH, Park CM, Lim HC. Meniscal flounce on MR: correlation with arthroscopic or surgical findings. Yonsei Med J. 2000;41(4):507–11.CrossRef
6.
go back to reference Park JS, Ryu KN, Yoon KH. Meniscal flounce on knee MRI: correlation with meniscal locations after positional changes. AJR Am J Roentgenol. 2006;187(2):364–70.CrossRef Park JS, Ryu KN, Yoon KH. Meniscal flounce on knee MRI: correlation with meniscal locations after positional changes. AJR Am J Roentgenol. 2006;187(2):364–70.CrossRef
7.
go back to reference Wright RW, Boyer DS. Significance of the arthroscopic meniscal flounce sign: a prospective study. Am J Sports Med. 2007;35(2):242–4.CrossRef Wright RW, Boyer DS. Significance of the arthroscopic meniscal flounce sign: a prospective study. Am J Sports Med. 2007;35(2):242–4.CrossRef
8.
go back to reference Wadhwa V, Omar H, Coyner K, Khazzam M, Robertson W, Chhabra A. ISAKOS classification of meniscal tears-illustration on 2D and 3D isotropic spin echo MR imaging. Eur J Radiol. 2016;85(1):15–24.CrossRef Wadhwa V, Omar H, Coyner K, Khazzam M, Robertson W, Chhabra A. ISAKOS classification of meniscal tears-illustration on 2D and 3D isotropic spin echo MR imaging. Eur J Radiol. 2016;85(1):15–24.CrossRef
9.
go back to reference Kolman BH, Daffner RH, Sciulli RL, Soehnlen MW. Correlation of joint fluid and internal derangement on knee MRI. Skelet Radiol. 2004;33(2):91–5.CrossRef Kolman BH, Daffner RH, Sciulli RL, Soehnlen MW. Correlation of joint fluid and internal derangement on knee MRI. Skelet Radiol. 2004;33(2):91–5.CrossRef
10.
go back to reference Dornacher D, Trubrich A, Guelke J, Reichel H, Kappe T. Evaluation of a modified knee rotation angle in MRI scans with and without trochlear dysplasia: a parameter independent of knee size and trochlear morphology. Knee Surg Sports Traumatol Arthrosc. 2017;25(8):2447–52.CrossRef Dornacher D, Trubrich A, Guelke J, Reichel H, Kappe T. Evaluation of a modified knee rotation angle in MRI scans with and without trochlear dysplasia: a parameter independent of knee size and trochlear morphology. Knee Surg Sports Traumatol Arthrosc. 2017;25(8):2447–52.CrossRef
11.
go back to reference Kim E, Kim YJ, Cha JG, Kim MY, Lee DH, Cho SG, et al. Kinematic change of the meniscus and the tibiofemoral joint space in asymptomatic volunteers using a wide bore 3T closed MRI system. Skelet Radiol. 2015;44(10):1441–51.CrossRef Kim E, Kim YJ, Cha JG, Kim MY, Lee DH, Cho SG, et al. Kinematic change of the meniscus and the tibiofemoral joint space in asymptomatic volunteers using a wide bore 3T closed MRI system. Skelet Radiol. 2015;44(10):1441–51.CrossRef
12.
go back to reference Rubin DA, Palmer WE. Imaging of the knee. In: Hodler J, von Schulthess G, Zollikofer CL, editors. Diagnostic Imaging and Interventional Techniques. Verlag: Springer; 2005. p. 26–38. Rubin DA, Palmer WE. Imaging of the knee. In: Hodler J, von Schulthess G, Zollikofer CL, editors. Diagnostic Imaging and Interventional Techniques. Verlag: Springer; 2005. p. 26–38.
13.
go back to reference Rath E, Richmond JC. The menisci: basic science and advances in treatment. Br J Sports Med. 2000;34(4):252–7.CrossRef Rath E, Richmond JC. The menisci: basic science and advances in treatment. Br J Sports Med. 2000;34(4):252–7.CrossRef
14.
go back to reference Gupte CM, Bull AM, Thomas RD, Amis AA. A review of the function and biomechanics of the meniscofemoral ligaments. Arthroscopy. 2003;19(2):161–71.CrossRef Gupte CM, Bull AM, Thomas RD, Amis AA. A review of the function and biomechanics of the meniscofemoral ligaments. Arthroscopy. 2003;19(2):161–71.CrossRef
15.
go back to reference Jee W-H, McCauley TR, Kim J-M, Jun D-J, Lee Y-J, Choi B-G, et al. Meniscal tear configurations: categorization with MR imaging. Am J Roentgenol. 2003;180(1):93–7.CrossRef Jee W-H, McCauley TR, Kim J-M, Jun D-J, Lee Y-J, Choi B-G, et al. Meniscal tear configurations: categorization with MR imaging. Am J Roentgenol. 2003;180(1):93–7.CrossRef
16.
go back to reference Barile A, Conti L, Lanni G, Calvisi V, Masciocchi C. Evaluation of medial meniscus tears and meniscal stability: weight-bearing MRI vs arthroscopy. Eur J Radiol. 2013;82(4):633–9.CrossRef Barile A, Conti L, Lanni G, Calvisi V, Masciocchi C. Evaluation of medial meniscus tears and meniscal stability: weight-bearing MRI vs arthroscopy. Eur J Radiol. 2013;82(4):633–9.CrossRef
17.
go back to reference Villegas DF, Hansen TA, Liu DF, Donahue TLH. A quantitative study of the microstructure and biochemistry of the medial meniscal horn attachments. Ann Biomed Eng. 2008;36(1):123–31.CrossRef Villegas DF, Hansen TA, Liu DF, Donahue TLH. A quantitative study of the microstructure and biochemistry of the medial meniscal horn attachments. Ann Biomed Eng. 2008;36(1):123–31.CrossRef
18.
go back to reference Stephen JM, Halewood C, Kittl C, Bollen SR, Williams A, Amis AA. Posteromedial meniscocapsular lesions increase tibiofemoral joint laxity with anterior cruciate ligament deficiency, and their repair reduces laxity. Am J Sports Med. 2016;44(2):400–8.CrossRef Stephen JM, Halewood C, Kittl C, Bollen SR, Williams A, Amis AA. Posteromedial meniscocapsular lesions increase tibiofemoral joint laxity with anterior cruciate ligament deficiency, and their repair reduces laxity. Am J Sports Med. 2016;44(2):400–8.CrossRef
19.
go back to reference DePhillipo NN, Moatshe G, Brady A, Chahla J, Aman ZS, Dornan GJ, et al. Effect of meniscocapsular and meniscotibial lesions in ACL-deficient and ACL-reconstructed knees: a biomechanical study. Am J Sports Med. 2018;46(10):2422–31.CrossRef DePhillipo NN, Moatshe G, Brady A, Chahla J, Aman ZS, Dornan GJ, et al. Effect of meniscocapsular and meniscotibial lesions in ACL-deficient and ACL-reconstructed knees: a biomechanical study. Am J Sports Med. 2018;46(10):2422–31.CrossRef
20.
go back to reference Watanabe Y, Van Scyoc A, Tsuda E, Debski RE, Woo SL. Biomechanical function of the posterior horn of the medial meniscus: a human cadaveric study. J Orthop Sci. 2004;9(3):280–4.CrossRef Watanabe Y, Van Scyoc A, Tsuda E, Debski RE, Woo SL. Biomechanical function of the posterior horn of the medial meniscus: a human cadaveric study. J Orthop Sci. 2004;9(3):280–4.CrossRef
21.
go back to reference Crawford R, Walley G, Bridgman S, Maffulli N. Magnetic resonance imaging versus arthroscopy in the diagnosis of knee pathology, concentrating on meniscal lesions and ACL tears: a systematic review. Br Med Bull. 2007;84:5–23.CrossRef Crawford R, Walley G, Bridgman S, Maffulli N. Magnetic resonance imaging versus arthroscopy in the diagnosis of knee pathology, concentrating on meniscal lesions and ACL tears: a systematic review. Br Med Bull. 2007;84:5–23.CrossRef
Metadata
Title
Association of meniscal flounce in the knee with the pattern and location of meniscal tear, concomitant ligamentous injury, amount of knee joint effusion, and flexion and rotation angles: a magnetic resonance evaluation
Authors
Hyo Jin Kim
Joong Mo Ahn
Youngjune Kim
Yusuhn Kang
Eugene Lee
Joon Woo Lee
Heung-Sik Kang
Publication date
01-08-2020
Publisher
Springer Berlin Heidelberg
Published in
Skeletal Radiology / Issue 8/2020
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-020-03416-w

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