Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 26, Issue 12, pp 3731–3737 | Cite as

Meniscal root tears occur frequently in multi-ligament knee injury and can be predicted by associated MRI injury patterns

  • Jonathan D. KosyEmail author
  • Luigi Matteliano
  • Anshul Rastogi
  • Dawn Pearce
  • Daniel B. Whelan



The frequency of meniscal root tears in association with multi-ligament knee injury has not been established but adds to the complexity of surgical reconstruction and may have long-term consequences. Therefore, identifying root tears, on preoperative imaging, is important. The aim of this study was to identify the frequency of meniscal root tears, on preoperative magnetic resonance imaging, following multi-ligament injury and distinguish associated injury patterns that may aid detection.


Cases were identified from a prospectively collected institutional database. The magnetic resonance imaging of 188 multi-ligament injuries [median age 31 years (range 16–64)] was retrospectively reviewed by three musculoskeletal radiologists with the presence of meniscal injuries recorded alongside the ligament injury pattern and intra-articular fractures. Assessment of injury pattern was solely made on this imaging.


38 meniscal root injuries were identified in 37 knees (overall frequency = 20.2%; medial = 10.6%; lateral = 9.6%). The frequency of meniscal root tears was not increased in higher grade injuries (21.5% vs. 17.0%, n.s.). Valgus injury patterns were associated with lateral root tears (p < 0.05) and varus patterns were associated with medial root tears (p < 0.05). Further, fractures in the same compartment were associated with both medial and lateral root tears (p < 0.05).


Meniscal root tears occur more frequently in multi-ligament knee injury than previously reported with isolated anterior cruciate rupture. Root tears can be predicted by ligament injury patterns and fractures sustained (suggestive of a compressive force). In multi-ligament cases, the preoperative magnetic resonance imaging can be used to detect these tears and associated patterns of injury.

Level of evidence



Multi-ligament injury Knee dislocation Meniscal root tear Magnetic resonance imaging Radiologic 



No external funding was used.

Compliance with ethical standards

Conflict of interest

We declare that we have no conflicts of interest in the authorship or publication of this contribution.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study formal consent is not required.


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Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2018

Authors and Affiliations

  • Jonathan D. Kosy
    • 1
    Email author
  • Luigi Matteliano
    • 1
  • Anshul Rastogi
    • 2
  • Dawn Pearce
    • 1
  • Daniel B. Whelan
    • 1
  1. 1.St Michael’s HospitalTorontoCanada
  2. 2.New Victoria HospitalKingston Upon ThamesUK

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