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Lateral–medial asymmetry of posterior tibial slope and small lateral tibial plateau articular surface depth are morphological factors of lateral meniscus posterior root tears in ACL-injured patients

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To investigate whether knee morphological features, patient characteristics, and intraoperative findings are associated with a lateral meniscus (LM) posterior root tear (LMPRT) in anterior cruciate ligament (ACL) injuries with the integrated data from two academic centres.

Methods

This retrospective study used registry data acquired prospectively at two academic centres. Patients with ACL reconstruction (ACLR) with LMPRT and no other LM injury were selected (LMPRT group) from each database. The control group included patients who underwent ACLR without LM tears. Patients were matched to the LMPRT group according to age and gender (1:1). Morphological factors evaluated on preoperative magnetic resonance image scans included lateral femoral condyle (LFC) anterior–posterior diameter, height, and depth; lateral tibial plateau (LTP) articular surface (AS) depth and sagittal plane depth; and lateral and medial posterior tibial slopes (PTSs). LFC height and depth ratios, LTP AS depth and sagittal plane depth ratios, and lateral-to-medial slope asymmetry were computed from previous measurements. Patient characteristics and intraoperative findings were extracted and compared between both groups.

Results

The study included 252 patients (126 in each group). The lateral–medial asymmetry of PTS was greater in the LMPRT group (1.2° vs 0.3°, p < 0.05), and the LTP AS depth was smaller in the LMPRT group (31.4 mm vs 33.2 mm, p < 0.01). There were no differences in LFC morphology between the control and LMPRT groups. Pivot shift grade (p < 0.05), percentage of complete ACL tears (p < 0.05), and medial meniscus ramp lesions (p < 0.05) were significantly higher in the LMPRT group.

Conclusion

LMPRT was associated with significantly increased lateral–medial asymmetry of PTS and significantly smaller LTP AS depth. LMPRT was also associated with an increase in the preoperative pivot shift grade and the presence of a medial meniscus ramp lesion. These morphological characteristics are rather simple to measure and would serve as helpful indicators to preoperatively detect LMPRT, which is frequently challenging to diagnose preoperatively.

Level of evidence

Level III.

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Data availability

The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors thank Miyoko Ojima for management in Tokyo Medical and Dental University, Masayo Tsukamoto for organizing data from Tokyo Medical and Dental University, and Editage (www.editage.com) for English language editing.

Funding

This study received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Author information

Author notes

  1. Aritoshi Yoshihara and Renaud Siboni contributed equally to this work.

Authors and Affiliations

  1. Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan

    Aritoshi Yoshihara, Yusuke Nakagawa, Tomomasa Nakamura & Hideyuki Koga

  2. Department of Orthopaedic Surgery, Centre Hospitalier Luxembourg-Clinique d’Eich, Luxembourg, Luxembourg

    Renaud Siboni, Caroline Mouton, Christophe Jacquet & Romain Seil

  3. Department of Orthopedics Surgery, Reims Teaching Hospital, Reims, France

    Renaud Siboni

  4. Sports Medicine and Science, Luxembourg Institute of Research in Orthopaedics, Luxembourg, Luxembourg

    Caroline Mouton & Romain Seil

  5. Department of Orthopaedic Surgery and Traumatology, Institute for Movement and Locomotion, St. Marguerite Hospital, Marseille, France

    Christophe Jacquet

  6. Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Tokyo, Japan

    Ichiro Sekiya

  7. Orthopaedics, Sports Medicine and Digital Methods, Human Motion, Luxembourg, Luxembourg

    Romain Seil

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  1. Aritoshi Yoshihara
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Contributions

AY conceived the study, managed data, performed statistical analysis, participated in study design, and wrote the manuscript. RSi managed data, participated in study design and wrote the manuscript. YN and CM participated in study design, advised statistical analysis, interpreted results, and edited the manuscript. CJ, TN and IS participated in study design and interpreted results. RSe and HK had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. All authors read, approved the final manuscript and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Corresponding author

Correspondence to Hideyuki Koga.

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The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the Institutional Review Board in Tokyo Medical and Dental University (M2000-2054) in Tokyo and the National Ethics Committee for Research (No. 201101/05 version 1.0) in Luxembourg.

Informed consent

All study participants provided their full written informed consent for participation in this clinical research prior to the operative procedure.

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Yoshihara, A., Siboni, R., Nakagawa, Y. et al. Lateral–medial asymmetry of posterior tibial slope and small lateral tibial plateau articular surface depth are morphological factors of lateral meniscus posterior root tears in ACL-injured patients. Knee Surg Sports Traumatol Arthrosc 31, 3594–3603 (2023). https://doi.org/10.1007/s00167-023-07317-y

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