The Menisci pp 21-29 | Cite as

Classification of Meniscal Tears

Chapter

Abstract

The classification systems of meniscal tears strengthen the importance of the anatomical and biomechanical particularities of meniscus tissue, regarding the pattern and configuration of a meniscal tear. Each system of classification approaches a particular aspect of the meniscal structure according to its morphology, proximity to the blood supply, anatomical site, and injury pattern. Meniscal traumatic lesions are characterized arthroscopically, as a lesion produced by a specific, well-known trauma on normal meniscal tissue, while degenerative meniscal tears are often related to a decompensation after minor trauma or even no known traumatic event. Moreover, in the degenerative condition, the meniscus substance exhibits macroscopic and microscopic alterations called myxoid degeneration. Classifying meniscal tears offers the knee surgeon the opportunity to identify and define an adequate treatment approach based on the literature for each specific meniscal tear. Moreover, it allows the surgeon to group meniscal tears, analyze their outcomes, and share their personal experience on different meniscal tears with other knee surgeons.

Keywords

Meniscus tears Classification Meniscocapsular Hidden lesion 

References

  1. 1.
    Andersen AF, Irrgang JJ, Dunn W, Beaufils P, Cohen M, Cole BJ, Coolican M, Ferretti M, Glenn Jr RE, Johnson R, Neyret P, Ochi M, Panarella L, Siebold R, Spindler KP, Ait Si Selmi T, Verdonk P, Verdonk R, Yasuda K, Kowalchuk DA. Interobserver reliability of the international Society of Arthroscopy, Knee surgery and Orthopedic Sports Medicine (ISAKOS). Classification of meniscal tears. Am J Sports Med. 2011;39(5):926–32.CrossRefGoogle Scholar
  2. 2.
    Arnoczky SP, Warren RF. The microvasculature of the meniscus and its response to injury. An experimental study in the dog. Am J Sports Med. 1983;11(3):131–41.CrossRefPubMedGoogle Scholar
  3. 3.
    Bierdet RM. Intrasubstance meniscal tears. Clinical aspects and the role of MRI. Arch Orthop Trauma Surg. 1993;112(3):142–7.CrossRefGoogle Scholar
  4. 4.
    Binfield PM, Maffulli N, JB K. Patterns of meniscal tears associated with anterior cruciate ligament lesions in athletes. Injury. 1993;24:557–61.CrossRefPubMedGoogle Scholar
  5. 5.
    Chahla J, Dean CS, Moasthe G, Mitchell JJ, Cram TR, Yacuzzi C, LaPrade RF. Meniscal ramp lesions: anatomy, incidence, diagnosis and treatment. Orthop J Sports Med. 2016;4(7):1–7.CrossRefGoogle Scholar
  6. 6.
    Dorfmann H, Juan LH, Bonavarlet JP, Boyer T. Arthroscopy of degenerative lesions of the internal meniscus. Classification and treatment. Rev Rhum Mal Oteo-Articul. 1987;54(4):303–10.Google Scholar
  7. 7.
    Freutel M, Scholz NB, Seitz AM, Ignatus A, Durselen L. Mechanical properties and morphological analysis of the transitional zone between meniscal body and ligamentous meniscal attachments. J Biomech. 2015;48(8):1350–5.CrossRefPubMedGoogle Scholar
  8. 8.
    Klimkiewicz JJ, Shaffer B. Meniscal surgery 2002 update: indications and techniques for resection, repair, regeneration. Arthroscopy. 2002;18:14–25.CrossRefPubMedGoogle Scholar
  9. 9.
    LaPrade CM, James EW, Cram TR, Feagin JA, Engebretsen L, LaPrade RF. Meniscal tears: a classification system based on tear morphology. Am J Sports Med. 2015;43(2):363–9.CrossRefPubMedGoogle Scholar
  10. 10.
    McDermott ID, Masouros SD, Amis AA. Biomechanics of the menisci of the knee. Curr Orthop. 2008;22:193–201.CrossRefGoogle Scholar
  11. 11.
    Moatshe G, Chahla J, Slette E, Engebretsen L, LaPrade RF. Posterior root tears. Acta Orthopaedica. 2016;87(5):452–8.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Monllau JC, Léon A, Cugat R, Ballester J. Ring-shaped lateral meniscus. Arthroscopy. 1988;14(5):502–4.Google Scholar
  13. 13.
    Papalia R, Vasta S, Franceschi F, D’Adamio S, Maffulli N, Denaro V. Meniscal root tears: from basic science to ultimate surgery. British Med Bull. 2013;106:91–115.CrossRefGoogle Scholar
  14. 14.
    Peltier A, Lording TD, Lustig S, Servien E, Maubisson L, Neyret P. Posteromedial meniscal tears may be missed during anterior cruciate ligament reconstruction. Arthroscopy. 2015;31(4):691–8.CrossRefPubMedGoogle Scholar
  15. 15.
    Pereira H, Frias AM, Oliveira JM, Espregueira-Mendes J, Reis RL. Tissue engineering and regenerative strategies in meniscus lesions. Arthroscopy. 2011;27(12):1706–19.CrossRefPubMedGoogle Scholar
  16. 16.
    Sonnery-Cottet B, Conteduca J, Thaunat M, Gunepin FX, Seil R. Hidden lesions of the posterior horn of the medial meniscus: a systematic exploration of the concealed portion of the knee. Am J Sports Med. 2014 Apr;42(4):921–6.CrossRefPubMedGoogle Scholar
  17. 17.
    Stoller DW, Martin C, Crues 3rd JV, Kaplan L, Mink JH. Meniscal tears: pathologic correlation with MR imaging. Radiology. 1987;163(3):731–5.CrossRefPubMedGoogle Scholar
  18. 18.
    Trillat A, Dejour H. Considérations sur la chirurgie des ménisques du genou. Lyon Chir. 168 64(3):440–53.Google Scholar
  19. 19.
    Trillat A. Traumatic lesions of the internal meniscus of the knee. Anatomical classification and clinical diagnosis. Rev Chir Othop Reparatrice Appar Mot. 1962;48:551–60.Google Scholar
  20. 20.
    Watanabe M. Arthroscopy: the present state. Orthop Clin North Am. 1979;10(3):505–22.PubMedGoogle Scholar

Copyright information

© ISAKOS 2017

Authors and Affiliations

  1. 1.Department of Orthopedics and Traumatology, Exercise and Sports Medicine, School of Medical SciencesState University of Campinas, UNICAMPCampinasBrazil

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