Top

12-03-2025 | Wound Debridement | Review

MR imaging of pediatric meniscal retears: pearls and pitfalls – a pictorial review

Authors: Oladipupo Fagbongbe, Rida Salman, Indranil Kushare, Pritish Bawa, Jason Zarahi Amaral, J. Herman Kan

Abstract

Differentiating expected pediatric knee MRI post-operative changes and meniscal retear after primary repair or debridement may be challenging. This pictorial essay reviews treatment strategies for meniscal tears with or without underlying discoid morphology. MRI pearls and pitfalls to identify meniscal retears and differentiate them from normal post-treatment findings will be shown, geared toward pediatric musculoskeletal radiologists.

Graphical Abstract

Available only for authorised users

Liechti DJ, Constantinescu DS, Ridley TJ, Chahla J, Mitchell JJ, Vap AR (2019) Meniscal repair in pediatric populations: a systematic review of outcomes. Orthop J Sports Med 7:2325967119843355. https://doi.org/10.1177/2325967119843355CrossRefPubMedPubMedCentral

Kim SH, Lee H-J, Jang Y-H, Chun K-J, Park Y-B (2021) Diagnostic accuracy of magnetic resonance imaging in the detection of type and location of meniscus tears: comparison with arthroscopic findings. J Clin Med 10:606. https://doi.org/10.3390/jcm10040606CrossRefPubMedPubMedCentral

Kijowski R, Rosas H, Williams A, Liu F (2017) MRI characteristics of torn and untorn post-operative menisci. Skeletal Radiol 46:1353–1360. https://doi.org/10.1007/s00256-017-2695-5CrossRefPubMedPubMedCentral

Chapin R (2018) Imaging of the postoperative meniscus. Radiol Clin North Am 56:953–964. https://doi.org/10.1016/j.rcl.2018.06.007CrossRefPubMed

Fierstra S, White LM (2022) MR imaging of the postoperative meniscus. Magn Reson Imaging Clin N Am 30:351–362. https://doi.org/10.1016/j.mric.2021.11.012CrossRefPubMed

Cardello P, Gigli C, Ricci A, Chiatti L, Voglino N, Pofi E (2009) Retears of postoperative knee meniscus: findings on magnetic resonance imaging (MRI) and magnetic resonance arthrography (MRA) by using low and high field magnets. Skeletal Radiol 38:149–156. https://doi.org/10.1007/s00256-008-0600-yCrossRefPubMed

Shi B, Stinson Z, Nault ML, Brey J, Beck J (2022) Meniscus repair in pediatric athletes. Clin Sports Med 41:749–767. https://doi.org/10.1016/j.csm.2022.05.010CrossRefPubMed

Perkins CA, Busch MT, Christino MA, Willimon SC (2021) Saucerization and repair of discoid lateral menisci with peripheral rim instability: intermediate-term outcomes in children and adolescents. J Pediatr Orthop 41:23–27. https://doi.org/10.1097/BPO.0000000000001695CrossRefPubMed

Travascio F, Jackson AR (2017) The nutrition of the human meniscus: a computational analysis investigating the effect of vascular recession on tissue homeostasis. J Biomech 61:151–159. https://doi.org/10.1016/j.jbiomech.2017.07.019CrossRefPubMed

10.

Paxton ES, Stock MV, Brophy RH (2011) Meniscal repair versus partial meniscectomy: a systematic review comparing reoperation rates and clinical outcomes. Arthrosc J Arthrosc Relat Surg Off Publ Arthrosc Assoc N Am Int Arthrosc Assoc 27:1275–1288. https://doi.org/10.1016/j.arthro.2011.03.088CrossRef

11.

Kushare I, Klingele K, Samora W (2015) Discoid meniscus: diagnosis and management. Orthop Clin North Am 46:533–540. https://doi.org/10.1016/j.ocl.2015.06.007CrossRefPubMed

12.

Patel NM, Mundluru SN, Beck NA, Ganley TJ (2019) Which factors increase the risk of reoperation after meniscal surgery in children? Orthop J Sports Med 7:2325967119842885. https://doi.org/10.1177/2325967119842885CrossRefPubMedPubMedCentral

13.

Schweizer C, Hanreich C, Tscholl PM, Blatter S, Windhager R, Waldstein W (2024) Meniscal repair outcome in 3829 patients with a minimum follow-up from 2 years up to 5 years: a meta-analysis on the overall failure rate and factors influencing failure. Am J Sports Med 52:822–831. https://doi.org/10.1177/03635465231158385CrossRefPubMed

14.

Schweizer C, Hanreich C, Tscholl PM, Ristl R, Apprich S, Windhager R, Waldstein W (2022) Nineteen percent of meniscus repairs are being revised and failures frequently occur after the second postoperative year: a systematic review and meta-analysis with a minimum follow-up of 5 years. Knee Surg Sports Traumatol Arthrosc 30:2267–2276. https://doi.org/10.1007/s00167-021-06770-xCrossRefPubMed

15.

Kim S-G, Kim S-H, Baek J-H, Kim J-G, Jang K-M, Lim H-C, Bae J-H (2019) High incidence of subsequent re-operation following treatments for medial meniscus tears combined with anterior cruciate ligament reconstruction: second-look arthroscopic study. Knee Surg Relat Res 31:11. https://doi.org/10.1186/s43019-019-0009-zCrossRefPubMedPubMedCentral

16.

Magee T (2014) Accuracy of 3-Tesla MR and MR arthrography in diagnosis of meniscal retear in the post-operative knee. Skeletal Radiol 43:1057–1064. https://doi.org/10.1007/s00256-014-1895-5CrossRefPubMed

17.

Magee T, Shapiro M, Rodriguez J, Williams D (2003) MR arthrography of postoperative knee: for which patients is it useful? Radiology 229:159–163. https://doi.org/10.1148/radiol.2291020988CrossRefPubMed

18.

Schwach M, Grange S, Klasan A, Putnis S, Philippot R, Neri T (2023) MRI criteria for healing at 1 year after repair of a traumatic meniscal tear. Am J Sports Med 51:3693–3700. https://doi.org/10.1177/03635465231207838CrossRefPubMed

19.

Boutin RD, Fritz RC, Marder RA (2014) Magnetic resonance imaging of the postoperative meniscus: resection, repair, and replacement. Magn Reson Imaging Clin N Am 22:517–555. https://doi.org/10.1016/j.mric.2014.07.007CrossRefPubMed

20.

Willinger L, Herbst E, Diermeier T, Forkel P, Woertler K, Imhoff AB, Achtnich A (2019) High short-term return to sports rate despite an ongoing healing process after acute meniscus repair in young athletes. Knee Surg Sports Traumatol Arthrosc Off J ESSKA 27:215–222. https://doi.org/10.1007/s00167-018-5335-2CrossRef

21.

Amaral JZ, Salman R, McKay SD, Kan JH (2024) MRI diagnostic performance and strategies for identifying retears in treated pediatric discoid and non-discoid lateral meniscal repairs. Radiol Med (Torino). https://doi.org/10.1007/s11547-024-01884-xCrossRefPubMed

Title: MR imaging of pediatric meniscal retears: pearls and pitfalls – a pictorial review
Authors: Oladipupo Fagbongbe
Rida Salman
Indranil Kushare
Pritish Bawa
Jason Zarahi Amaral
J. Herman Kan
Publication date: 12-03-2025
Publisher: Springer Berlin Heidelberg
Keywords: Wound Debridement
Arthroscopy
Arthroscopy
Published in: Pediatric Radiology
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI: https://doi.org/10.1007/s00247-025-06211-8

Keynote webinar | Spotlight on adolescent vaping

Pediatrics
On-demand webinar

Growing numbers of young people are using e-cigarettes, despite warnings of respiratory effects and addiction. How can doctors tackle the epidemic, and what health effects should you prepare to manage in your clinics?

Prof. Ann McNeill

Dr. Debbie Robson

Benji Horwell

Developed by: Springer Medicine

Watch now

Podcast | Sexual health in older age

Springer Medicine

Abstract

Graphical Abstract

Please log in to get access to this content

Keynote webinar | Spotlight on adolescent vaping