Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 1/2015

01-01-2015 | Knee

Medial meniscus tear morphology and related clinical symptoms in patients with medial knee osteoarthritis

Authors: Masayuki Kamimura, Jutaro Umehara, Atsushi Takahashi, Toshimi Aizawa, Eiji Itoi

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 1/2015

Login to get access

Abstract

Purpose

The objective of this study was to examine the association between clinical symptoms and arthroscopic meniscal findings in patients with early to moderate medial knee osteoarthritis.

Methods

One hundred and four patients (110 knees) were selected from a group of 132 patients (140 knees) aged ≥50 years who underwent arthroscopic surgery for medial meniscal tears. Inclusion criteria were as follows: (a) medial knee osteoarthritis and (b) simple medial meniscal tears extending to ≥1/4 of the meniscal margin. Subjective symptoms, location and nature of the pain, as well as the physical findings observed during initial assessment were evaluated using a standardized assessment chart. The relationship between arthroscopic meniscal findings and clinical symptoms was then analysed.

Results

Isolated meniscal tears were classified into four types: radial tear of the middle segment; posterior root tear; horizontal tear of the posterior segment; and flap tear. The following symptoms were reported at significantly higher frequencies: pain on standing and a catching sensation in patients with flap tears; pain on walking and nocturnal pain on rolling over in bed in patients with radial tears of the middle segment; and popliteal pain in patients with posterior root tears.

Conclusions

This study demonstrates a relationship between the type of medial meniscal tear and characteristic clinical symptoms reported by patients with medial knee osteoarthritis. These results suggest that clinical symptoms in patients with osteoarthritis of the knee may be caused by meniscal tears. This evidence may help to better inform patients and surgeons regarding choice of treatment.

Level of evidence

Case control study, Level III.
Literature
1.
Allaire R, Muriuki M, Gilbertson L, Harner CD (2008) Biomechanical consequences of a tear of the posterior root of the medial meniscus: similar to total meniscectomy. J Bone Joint Surg Am 90:1922–1931PubMedCrossRef
2.
Bhattacharyya T, Gale D, Dewire P, Totterman S, Gale ME, McLaughlin S, Einhorn TA, Felson DT (2003) The clinical importance of meniscal tears demonstrated by magnetic resonance imaging in osteoarthritis of the knee. J Bone Joint Surg Am 85:4–9PubMed
3.
Bin SI, Kim JM, Shin SJ (2004) Radial tears of the posterior horn of the medial meniscus. Arthroscopy 20:373–378PubMedCrossRef
4.
Bin SI, Lee SH, Kim CW, Kim TH, Lee DH (2008) Results of arthroscopic medial meniscectomy in patients with grade IV osteoarthritis of the medial compartment. Arthroscopy 24:264–268PubMedCrossRef
5.
Choi CJ, Choi YJ, Song IB, Choi CH (2011) Characteristics of radial tears in the posterior horn of the medial meniscus compared to horizontal tears. Clin Orthop Surg 3:128–132PubMedCentralPubMedCrossRef
6.
Christoforakis J, Pradhan R, Sanchez-Ballester J, Hunt N, Strachan RK (2005) Is there an association between articular cartilage changes and degenerative meniscus tears? Arthroscopy 21:1366–1369PubMedCrossRef
7.
Crevoisier X, Munzinger U, Drobny T (2001) Arthroscopic partial meniscectomy in patients over 70 years of age. Arthroscopy 17:732–736PubMedCrossRef
8.
Dandy DJ (1990) The arthroscopic anatomy of symptomatic meniscal lesions. J Bone Joint Surg Br 72:628–633PubMed
9.
Day B, Mackenzie WG, Shim SS, Leung G (1985) The vascular and nerve supply of the human meniscus. Arthroscopy 1:58–62PubMedCrossRef
10.
Dervin GF, Stiell IG, Rody K, Grabowski J (2003) Effect of arthroscopic debridement for osteoarthritis of the knee on health-related quality of life. J Bone Joint Surg Am 85:10–19PubMed
11.
Dervin GF, Stiell IG, Wells GA, Rody K, Grabowski J (2001) Physicians’ accuracy and interrator reliability for the diagnosis of unstable meniscal tears in patients having osteoarthritis of the knee. Can J Surg 44:267–274PubMedCentralPubMed
12.
Englund M, Guermazi A, Gale D, Hunter DJ, Aliabadi P, Clancy M, Felson DT (2008) Incidental meniscal findings on knee MRI in middle-aged and elderly persons. N Engl J Med 359:1108–1115PubMedCentralPubMedCrossRef
13.
Englund M, Guermazi A, Roemer FW, Aliabadi P, Yang M, Lewis CE, Torner J, Nevitt MC, Sack B, Felson DT (2009) Meniscal tear in knees without surgery and the development of radiographic osteoarthritis among middle-aged and elderly persons: the Multicenter Osteoarthritis Study. Arthritis Rheum 60:831–839PubMedCentralPubMedCrossRef
14.
Englund M, Niu J, Guermazi A, Roemer FW, Hunter DJ, Lynch JA, Lewis CE, Torner J, Nevitt MC, Zhang YQ, Felson DT (2007) Effect of meniscal damage on the development of frequent knee pain, aching, or stiffness. Arthritis Rheum 56:4048–4054PubMedCrossRef
15.
Englund M, Roos EM, Lohmander LS (2003) Impact of type of meniscal tear on radiographic and symptomatic knee osteoarthritis: a sixteen-year followup of meniscectomy with matched controls. Arthritis Rheum 48:2178–2187PubMedCrossRef
16.
Felson DT, Chaisson CE, Hill CL, Totterman SM, Gale ME, Skinner KM, Kazis L, Gale DR (2001) The association of bone marrow lesions with pain in knee osteoarthritis. Ann Intern Med 134:541–549PubMedCrossRef
17.
Habata T, Uematsu K, Hattori K, Takakura Y, Fujisawa Y (2004) Clinical features of the posterior horn tear in the medial meniscus. Arch Orthop Trauma Surg 124:642–645PubMedCrossRef
18.
Herrlin S, Hallander M, Wange P, Weidenhielm L, Werner S (2007) Arthroscopic or conservative treatment of degenerative medial meniscal tears: a prospective randomised trial. Knee Surg Sports Traumatol Arthrosc 15:393–401PubMedCrossRef
19.
Herrlin SV, Wange PO, Lapidus G, Hallander M, Werner S, Weidenhielm L (2013) Is arthroscopic surgery beneficial in treating non-traumatic, degenerative medial meniscal tears? a five year follow-up. Knee Surg Sports Traumatol Arthrosc 21:358–364PubMedCrossRef
20.
Hunter DJ, Zhang YQ, Niu JB, Tu X, Amin S, Clancy M, Guermazi A, Grigorian M, Gale D, Felson DT (2006) The association of meniscal pathologic changes with cartilage loss in symptomatic knee osteoarthritis. Arthritis Rheum 54:795–801PubMedCrossRef
21.
Jones AO, Houang MT, Low RS, Wood DG (2006) Medial meniscus posterior root attachment injury and degeneration: mRI findings. Australas Radiol 50:306–313PubMedCrossRef
22.
23.
Matsusue Y, Thomson NL (1996) Arthroscopic partial medial meniscectomy in patients over 40 years old: a 5- to 11-year follow-up study. Arthroscopy 12:39–44PubMedCrossRef
24.
Metcalf MH, Barrett GR (2004) Prospective evaluation of 1485 meniscal tear patterns in patients with stable knees. Am J Sports Med 32:675–680PubMedCrossRef
25.
Neogi DS, Kumar A, Rijal L, Yadav CS, Jaiman A, Nag HL (2013) Role of nonoperative treatment in managing degenerative tears of the medial meniscus posterior root. J Orthop Traumatol 14:193–199PubMedCentralPubMedCrossRef
26.
Noble J, Hamblen DL (1975) The pathology of the degenerate meniscus lesion. J Bone Joint Surg Br 57:180–186PubMed
27.
Ozkoc G, Circi E, Gonc U, Irgit K, Pourbagher A, Tandogan RN (2008) Radial tears in the root of the posterior horn of the medial meniscus. Knee Surg Sports Traumatol Arthrosc 16:849–854PubMedCrossRef
28.
Pena E, Calvo B, Martinez MA, Palanca D, Doblare M (2005) Finite element analysis of the effect of meniscal tears and meniscectomies on human knee biomechanics. Clin Biomech (Bristol, Avon) 20:498–507CrossRef
29.
Pujol N, Bohu Y, Boisrenoult P, Macdes A, Beaufils P (2013) Clinical outcomes of open meniscal repair of horizontal meniscal tears in young patients. Knee Surg Sports Traumatol Arthrosc 21:1530–1533PubMedCrossRef
30.
Robertson DD, Armfield DR, Towers JD, Irrgang JJ, Maloney WJ, Harner CD (2009) Meniscal root injury and spontaneous osteonecrosis of the knee: an observation. J Bone Joint Surg Br 91:190–195PubMedCrossRef
31.
Roos EM, Ostenberg A, Roos H, Ekdahl C, Lohmander LS (2001) Long-term outcome of meniscectomy: symptoms, function, and performance tests in patients with or without radiographic osteoarthritis compared to matched controls. Osteoarthr Cartil 9:316–324PubMedCrossRef
32.
Yao L, Stanczak J, Boutin RD (2004) Presumptive subarticular stress reactions of the knee: MRI detection and association with meniscal tear patterns. Skelet Radiol 33:260–264CrossRef
33.
Zanetti M, Pfirrmann CW, Schmid MR, Romero J, Seifert B, Hodler J (2003) Patients with suspected meniscal tears: prevalence of abnormalities seen on MRI of 100 symptomatic and 100 contralateral asymptomatic knees. AJR Am J Roentgenol 181:635–641PubMedCrossRef
Metadata
Title
Medial meniscus tear morphology and related clinical symptoms in patients with medial knee osteoarthritis
Authors
Masayuki Kamimura
Jutaro Umehara
Atsushi Takahashi
Toshimi Aizawa
Eiji Itoi
Publication date
01-01-2015
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 1/2015
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-014-2939-z

Other articles of this Issue 1/2015

Knee Surgery, Sports Traumatology, Arthroscopy 1/2015 Go to the issue

Knee

What is the best way to fix a polyurethane meniscal scaffold? A biomechanical evaluation of different fixation modes

Knee

Postarthroscopy osteonecrosis of the knee

Knee

Tibiofemoral loss of contact area but no changes in peak pressures after meniscectomy in a Lapine in vivo quadriceps force transfer model

Knee

Posterior root tears of the lateral meniscus

Knee

Meniscal allograft transplantation. Part 2: systematic review of transplant timing, outcomes, return to competition, associated procedures, and prevention of osteoarthritis

Knee

Short-term effects of partial meniscectomy on the clinical results of anterior cruciate ligament reconstruction