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Root Tear: Epidemiology, Pathophysiology, and Prognosis

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Knee Arthroscopy
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Abstract

Meniscus root tears are disruptions in the ligamentous portion connecting the meniscus to the tibia. Its clinical presentation, pathophysiology, and treatment have only been explored fairly recently, compared to other meniscus tear types. Meniscus root tears are a unique clinical entity in that tears in this region disrupt the circumferential hoop tension of the whole meniscus, possibly leading to total meniscectomy-like consequences in the knee joint. Recent findings regarding pathophysiology and prognosis suggest that degenerative root tears follow a different clinical course compared to acute tears. A clear understanding of tear pathophysiology is required to accurately diagnose and choose patients that would benefit from surgical repair.

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References

  1. Bin SI, Kim JM, Shin SJ. Radial tears of the posterior horn of the medial meniscus. Arthroscopy. 2004;20(4):373–8.

    Article  Google Scholar 

  2. Hwang BY, et al. Risk factors for medial meniscus posterior root tear. Am J Sports Med. 2012;40(7):1606–10.

    Article  Google Scholar 

  3. Ozkoc G, et al. Radial tears in the root of the posterior horn of the medial meniscus. Knee Surg Sports Traumatol Arthrosc. 2008;16(9):849–54.

    Article  Google Scholar 

  4. Ahn JH, et al. Double transosseous pull out suture technique for transection of posterior horn of medial meniscus. Arch Orthop Trauma Surg. 2009;129(3):387–92.

    Article  Google Scholar 

  5. Allaire R, et al. Biomechanical consequences of a tear of the posterior root of the medial meniscus. Similar to total meniscectomy. J Bone Joint Surg Am. 2008;90(9):1922–31.

    Google Scholar 

  6. Choi CJ, et al. Magnetic resonance imaging evidence of meniscal extrusion in medial meniscus posterior root tear. Arthroscopy. 2010;26(12):1602–6.

    Article  Google Scholar 

  7. Johnson DL, Swenson TM, Livesay GA, Aizawa H, Fu FH, Harner CD. Insertion-site anatomy of the human menisci: gross, arthroscopic, and topographical anatomy as a basis for meniscal transplantation. Arthroscopy. 1995;11(4):386–94.

    Article  CAS  Google Scholar 

  8. Park DY, et al. The degeneration of meniscus roots is accompanied by fibrocartilage formation, which may precede meniscus root tears in osteoarthritic knees. Am J Sports Med. 2015;43(12):3034–44.

    Article  Google Scholar 

  9. Anderson CJ, et al. Arthroscopically pertinent anatomy of the anterolateral and posteromedial bundles of the posterior cruciate ligament. J Bone Joint Surg Am. 2012;94(21):1936–45.

    Article  Google Scholar 

  10. Villegas DF, Donahue TL. Collagen morphology in human meniscal attachments: a SEM study. Connect Tissue Res. 2010;51(5):327–36.

    Article  Google Scholar 

  11. Papalia R, et al. Meniscal root tears: from basic science to ultimate surgery. Br Med Bull. 2013;106:91–115.

    Article  CAS  Google Scholar 

  12. Lee DH, et al. Predictors of degenerative medial meniscus extrusion: radial component and knee osteoarthritis. Knee Surg Sports Traumatol Arthrosc. 2011;19(2):222–9.

    Article  Google Scholar 

  13. Kim YJ, et al. Posterior root tear of the medial meniscus in multiple knee ligament injuries. Knee. 2010;17(5):324–8.

    Article  Google Scholar 

  14. Bhatia S, et al. Meniscal root tears. Am J Sports Med. 2014;42(12):3016–30.

    Article  Google Scholar 

  15. De Smet AA, et al. MR diagnosis of posterior root tears of the lateral meniscus using arthroscopy as the reference standard. AJR Am J Roentgenol. 2009;192(2):480–6.

    Article  Google Scholar 

  16. Lerer DB, et al. The role of meniscal root pathology and radial meniscal tear in medial meniscal extrusion. Skeletal Radiol. 2004;33(10):569–74.

    Article  CAS  Google Scholar 

  17. Vedi, V., et al. Meniscal movement. An in-vivo study using dynamic MRI. J Bone Joint Surg Br. 1999;81(1):37–41.

    Google Scholar 

  18. Tibial meniscal dynamics using three-dimensional reconstruction of magnetic resonance images.pdf.

    Google Scholar 

  19. Shelbourne KD, Roberson TA, Gray T. Long-term evaluation of posterior lateral meniscus root tears left in situ at the time of anterior cruciate ligament reconstruction. Am J Sports Med. 2011;39(7):1439–43.

    Article  Google Scholar 

  20. Kim SB, et al. Medial meniscus root tear refixation: comparison of clinical, radiologic, and arthroscopic findings with medial meniscectomy. Arthroscopy. 2011;27(3):346–54.

    Article  Google Scholar 

  21. Ahn JH, et al. Results of arthroscopic all-inside repair for lateral meniscus root tear in patients undergoing concomitant anterior cruciate ligament reconstruction. Arthroscopy. 2010;26(1):67–75.

    Article  Google Scholar 

  22. Jung YH, et al. All-inside repair for a root tear of the medial meniscus using a suture anchor. Am J Sports Med. 2012;40(6):1406–11.

    Article  Google Scholar 

  23. Kim JH, et al. Arthroscopic suture anchor repair versus pullout suture repair in posterior root tear of the medial meniscus: a prospective comparison study. Arthroscopy. 2011;27(12):1644–53.

    Article  Google Scholar 

  24. Lee JH, et al. Arthroscopic pullout suture repair of posterior root tear of the medial meniscus: radiographic and clinical results with a 2-year follow-up. Arthroscopy. 2009;25(9):951–8.

    Article  Google Scholar 

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Correspondence to Byounghun Min .

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Min, B., Park, D.Y. (2021). Root Tear: Epidemiology, Pathophysiology, and Prognosis . In: Kim, J.G. (eds) Knee Arthroscopy. Springer, Singapore. https://doi.org/10.1007/978-981-15-8191-5_19

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  • DOI: https://doi.org/10.1007/978-981-15-8191-5_19

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-15-8190-8

  • Online ISBN: 978-981-15-8191-5

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