Lack of posteromedial tibiofemoral congruence at full flexion as a causative factor in isolated medial meniscal tears

Abstract.

The aim of the current study was to investigate posteromedial tibiofemoral congruence at full flexion of the knee in control knee joints and those affected by an isolated medial meniscal tear, to examine whether lack of such congruence was a causative factor in isolated medial meniscal tears. In this study, 1677 knee joints in 875 subjects were evaluated. The joints were classified as a control group (1345 joints), an isolated medial meniscal tear group (224 joints), and a contralateral isolated medial meniscal tear group (108 joints). Posteromedial tibiofemoral congruence was examined on a lateral radiograph of the knee joint at full flexion. The tangent touching the anterior and posterior parts of the articular surface of the medial tibial condyle was assumed to be the X-axis. To evaluate posteromedial tibiofemoral congruence, we measured the angle formed by the tangent that maximized the gradient of the tangent on the articular surface of the medial femoral condyle, and the tangent that maximized the gradient of the tangent on the articular surface of the medial tibial condyle. The mean angle differed significantly between the control and the isolated medial meniscal tear groups, regardless of sex. Isolated medial meniscal tears were found to be strongly related to an abnormally decreased angle, and, therefore, incongruence of the posteromedial tibiofemoral articulation at full flexion was considered to be one of the causes of isolated medial meniscal tears.