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Widening of the popliteal hiatus on sagittal MRI view plays a critical role in the mechanical signs of discoid lateral meniscus

Abstract

Purpose

This study was undertaken to elucidate the clinical significance of widening of the popliteal hiatus on magnetic resonance imaging (MRI) after a torn discoid lateral meniscus (DLM).

Methods

Included are 125 knees with meniscal disorders after arthroscopic surgery, divided according to preoperative MRI and symptoms into group A (torn DLM with mechanical symptoms,11 knees); group B (torn DLM without mechanical symptoms,41 knees); group C (asymptomatic DLM, 19 knees); and group D (medial meniscal tears, 54 knees). Popliteal hiatus width was measured on sagittal and coronal MRI. During arthroscopy, total meniscectomy or central partial meniscectomy combined repair of the remaining part was performed in group A and group B. Outcomes were evaluated with MRI, the Tegner, Lysholm Knee Scoring Scale, and visual analog scale (VAS) scores.

Results

The preoperative width of the popliteal hiatus was significantly larger in group A than in groups C and D (P < 0.05) on both views. Group A had a wider popliteal hiatus on sagittal view compared with group B (P < 0.05); group B had a wider popliteal hiatus on coronal view compared with group D (P < 0.05). The width of the popliteal hiatus on sagittal view was significantly reduced after surgery in group A (P < 0.05). In groups A and B, Lysholm and Tegner scores were improved, while VAS scores were reduced (all P < 0.05).

Conclusion

Widening of the popliteal hiatus on MRI was correlated with torn DLM and accompanied mechanical symptoms. Arthroscopic central partial menisectomy and stabilization of the posterior part of the middle body anterior to the popliteus tendon were effective for the treatment of torn DLM. These findings may help guide appropriate treatment for torn DLM.

Level of evidence

II.

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Acknowledgements

We thank Dr. Zhijun Yang for assistance in the statistical analysis of our data and preparation of figures of this article.

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Correspondence to Zhu Dai.

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Conflict of interest

This work was supported by grants from the Natural Science Foundation of Hunan Province (2019JJ40270), and grants from the Scientific Research Fund Project of Hunan Province Health Commission (20201907). Zhou Li, Weijie Fan, Zhu Dai, Heng Zhao, Ying Liao, Yunliang Lei, Tao Luo, Quanhui Liu, Jian Li declare that they have no conflict of interest.

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Approval for this study was obtained from the ethics committee of the First Affiliated Hospital of University of South China and informed consent forms were signed by each patient included in this study.

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Li, Z., Fan, W., Dai, Z. et al. Widening of the popliteal hiatus on sagittal MRI view plays a critical role in the mechanical signs of discoid lateral meniscus. Knee Surg Sports Traumatol Arthrosc 29, 2843–2850 (2021). https://doi.org/10.1007/s00167-020-06179-y

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Keywords

  • Knee
  • Popliteal hiatus
  • Discoid lateral meniscus
  • MRI
  • Arthroscopy