Skip to main content
Top
Published in: BMC Musculoskeletal Disorders 1/2015

Open Access 01-12-2015 | Research article

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

Authors: Yogendra Gupta, Deepak Prakash Mahara, Arjun Prasad Lamichhane

Published in: BMC Musculoskeletal Disorders | Issue 1/2015

Login to get access

Abstract

Background

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.

Methods

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.

Results

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).

Conclusion

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.
Literature
1.
go back to reference Kim S, Bosque J, Meehan JP, Jamali A, Marder R. Increase in outpatient knee arthroscopy in the United States: a comparison of national surveys of ambulatory surgery, 1996 and 2006. J Bone Joint Surg Am. 2011;93:994–1000. doi:10.2106/JBJS.I.01618.CrossRefPubMed Kim S, Bosque J, Meehan JP, Jamali A, Marder R. Increase in outpatient knee arthroscopy in the United States: a comparison of national surveys of ambulatory surgery, 1996 and 2006. J Bone Joint Surg Am. 2011;93:994–1000. doi:10.​2106/​JBJS.​I.​01618.CrossRefPubMed
2.
go back to reference Williams AM, Myers PT, Watt MC, Hewitt BJ, Owen LE, McMeniman PJ. The meniscal flounce: a valuable arthroscopic sign. Knee. 2006;13:337–41.CrossRefPubMed Williams AM, Myers PT, Watt MC, Hewitt BJ, Owen LE, McMeniman PJ. The meniscal flounce: a valuable arthroscopic sign. Knee. 2006;13:337–41.CrossRefPubMed
3.
go back to reference Wright RW, Boyer DS. Significance of the arthroscopic meniscal flounce sign: a prospective study. Am J Sports Med. 2007;35:242–5.CrossRefPubMed Wright RW, Boyer DS. Significance of the arthroscopic meniscal flounce sign: a prospective study. Am J Sports Med. 2007;35:242–5.CrossRefPubMed
4.
go back to reference Watanabe M, Takeda S, Ikeuchi H. Atlas of arthroscopy. 3rd ed. Tokyo, Japan: Springer; 1979. Watanabe M, Takeda S, Ikeuchi H. Atlas of arthroscopy. 3rd ed. Tokyo, Japan: Springer; 1979.
6.
go back to reference Park JS, Ryu KN, Yoon KH. Meniscal flounce on knee MRI: correlation with meniscal locations after positional changes. AJR. 2006;187:364–70.CrossRefPubMed Park JS, Ryu KN, Yoon KH. Meniscal flounce on knee MRI: correlation with meniscal locations after positional changes. AJR. 2006;187:364–70.CrossRefPubMed
7.
go back to reference Yu JS, Cosgarea AJ, Kaeding CC, Wilson D. Meniscal flounce MR imaging. Radiology. 1997;230(3):513–5.CrossRef Yu JS, Cosgarea AJ, Kaeding CC, Wilson D. Meniscal flounce MR imaging. Radiology. 1997;230(3):513–5.CrossRef
8.
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.CrossRefPubMed 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.CrossRefPubMed
9.
go back to reference Lubowitz JH, Rossi MJ, Baker BS, Guttman D. Arthroscopic visualization of the posterior compartments of the knee. Arthroscopy. 2004;20(7):675–80.CrossRefPubMed Lubowitz JH, Rossi MJ, Baker BS, Guttman D. Arthroscopic visualization of the posterior compartments of the knee. Arthroscopy. 2004;20(7):675–80.CrossRefPubMed
Metadata
Title
Validity of flounce sign to rule out medial meniscus tear in knee arthroscopy
Authors
Yogendra Gupta
Deepak Prakash Mahara
Arjun Prasad Lamichhane
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2015
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-015-0800-2

Other articles of this Issue 1/2015

BMC Musculoskeletal Disorders 1/2015 Go to the issue