Skip to main content

Advertisement

SpringerLink
Log in

A posterior shiny-corner lesion of the tibia is observed in the early phase after medial meniscus posterior root tear

  • Original Article
  • Published:
European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Backgrounds

Medial meniscus (MM) posterior root tear (PRT) results in joint overloading and degenerative changes in the knee, and pullout repair is recommended to prevent subsequent osteoarthritis. Diagnosing MMPRT is sometimes difficult, especially in the case of an incomplete tear. A posterior shiny-corner lesion (PSCL) is reported to be useful for diagnosis, although the association between MMPRT and PSCL is unknown. This study aimed to investigate the properties of PSCL, such as the location, volume, and duration from injury to the time of MRI (duration). We hypothesized that PSCL is observed in the early phase after the MMPRT onset.

Methods

T2-weighted fat-suppression magnetic resonance imaging (MRI) was obtained from 55 patients with MMPRT preoperatively. The prevalence of the PSCL; giraffe neck, cleft, and ghost signs; severe MM extrusion (> 3 mm); and the PSCL volume were evaluated. The PSCL lesion elliptical volume (mm3) was calculated by measuring the anteroposterior, transverse, and craniocaudal dimensions.

Results

PSCL was observed in 34 (62%) cases. The mean volume of the PSCL was 102.0 mm3. A significantly shorter duration was observed in the PSCL-positive group (5.6 weeks) than that in the PSCL-negative group (40.9 weeks, P < 0.01), although no significant correlation was observed between the PSCL volume and duration. The sensitivity for the MMPRT was 90.5% when the cut-off duration value was 3 weeks and 81.8% when the cut-off value was 8 weeks.

Conclusions

MRI examination may detect PSCL if it is performed early following MMPRT onset. Detecting PSCL may be useful in diagnosing MMPRT with high sensitivity.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Bernard CD, Kennedy NI, Tagliero AJ, Camp CL, Saris DBF, Levy BA, Stuart MJ, Krych AJ (2020) Medial meniscus posterior root tear treatment: a matched cohort comparison of nonoperative management, partial meniscectomy, and repair. Am J Sports Med 48(1):128–132. https://doi.org/10.1177/0363546519888212

    Article  PubMed  Google Scholar 

  2. Chung KS, Noh JM, Ha JK, Ra HJ, Park SB, Kim HK, Kim JG (2018) Survivorship analysis and clinical outcomes of transtibial pullout repair for medial meniscus posterior root tears: A 5- to 10-year follow-up study. Arthrosc: J Arthrosc Relat Surg: Off Publication Arthrosc Assoc North Am Int Arthrosc Assoc 34(2):530–535. https://doi.org/10.1016/j.arthro.2017.08.266

    Article  Google Scholar 

  3. Hino T, Furumatsu T, Miyazawa S, Fujii M, Kodama Y, Kamatsuki Y, Okazaki Y, Masuda S, Okazaki Y, Ozaki T (2020) A histological study of the medial meniscus posterior root tibial insertion. Connect Tissue Res 61(6):546–553. https://doi.org/10.1080/03008207.2019.1631298

    Article  PubMed  Google Scholar 

  4. Sahoo K, Garg A, Saha P, Dodia JV, Raj VR, Bhairagond SJ (2016) Study of imaging pattern in bone marrow oedema in mri in recent knee injuries and its correlation with type of knee injury. Journal of Clinical and Diagnostic Research: JCDR 10(4): 06–11

  5. Sharif B, Ashraf T, Saifuddin A (2020) Magnetic resonance imaging of the meniscal roots. Skeletal Radiol 49(5):661–676. https://doi.org/10.1007/s00256-020-03374-3

    Article  PubMed  Google Scholar 

  6. Choi JY, Chang EY, Cunha GM, Tafur M, Statum S, Chung CB (2014) Posterior medial meniscus root ligament lesions: MRI classification and associated findings. AJR Am J Roentgenol 203(6):1286–1292. https://doi.org/10.2214/AJR.14.12559

    Article  PubMed  Google Scholar 

  7. Choi SH, Bae S, Ji SK, Chang MJ (2012) The MRI findings of meniscal root tear of the medial meniscus: emphasis on coronal, sagittal and axial images. Knee Surg, Sports Traumatol, Arthrosc: Off J ESSKA 20(10):2098–2103. https://doi.org/10.1007/s00167-011-1794-4

    Article  Google Scholar 

  8. Marzo JM, Gurske-DePerio J (2009) Effects of medial meniscus posterior horn avulsion and repair on tibiofemoral contact area and peak contact pressure with clinical implications. Am J Sports Med 37(1):124–129. https://doi.org/10.1177/0363546508323254

    Article  PubMed  Google Scholar 

  9. Sayyid S, Younan Y, Sharma G, Singer A, Morrison W, Zoga A, Gonzalez FM (2019) Subchondral insufficiency fracture of the knee: grading, risk factors, and outcome. Skeletal Radiol. https://doi.org/10.1007/s00256-019-03245-6

    Article  PubMed  Google Scholar 

  10. Bae JH, Paik NH, Park GW, Yoon JR, Chae DJ, Kwon JH, Kim JI, Nha KW (2013) Predictive value of painful popping for a posterior root tear of the medial meniscus in middle-aged to older Asian patients. Arthrosc:J Arthrosc Relat Surg: Off Publ Arthrosc Assoc North Am Int Arthrosc Assoc 29(3):545–549. https://doi.org/10.1016/j.arthro.2012.10.026

    Article  Google Scholar 

  11. Lee DW, Moon SG, Kim NR, Chang MS, Kim JG (2018) Medial knee osteoarthritis precedes medial meniscal posterior root tear with an event of painful popping. Orthopaedics Traumatol, Surg Res: OTSR 104(7):1009–1015. https://doi.org/10.1016/j.otsr.2018.07.010

    Article  Google Scholar 

  12. Chung KS, Ha JK, Ra HJ, Kim JG (2016) A meta-analysis of clinical and radiographic outcomes of posterior horn medial meniscus root repairs. Knee Surg, Sports Traumatol, Arthros: Off J ESSKA 24(5):1455–1468. https://doi.org/10.1007/s00167-015-3832-0

    Article  Google Scholar 

  13. Furumatsu T, Fujii M, Kodama Y, Ozaki T (2017) A giraffe neck sign of the medial meniscus: A characteristic finding of the medial meniscus posterior root tear on magnetic resonance imaging. J Orthopaedic Sci: Off J Jpn Orthopaedic Assoc 22(4):731–736. https://doi.org/10.1016/j.jos.2017.03.013

    Article  Google Scholar 

  14. Hiranaka T, Furumatsu T, Okazaki Y, Yamawaki T, Okazaki Y, Kodama Y, Kamatsuki Y, Ozaki T (2020) Steep medial tibial slope and prolonged delay to surgery are associated with bilateral medial meniscus posterior root tear. Knee Surg Sports Traumatol Arthrosc. https://doi.org/10.1007/s00167-020-06079-1

    Article  PubMed  Google Scholar 

  15. Okazaki Y, Furumatsu T, Kodama Y, Kamatsuki Y, Okazaki Y, Hiranaka T, Takihira S, Tetsunaga T, Saiga K, Ozaki T (2019) Steep posterior slope and shallow concave shape of the medial tibial plateau are risk factors for medial meniscus posterior root tears. Knee Surg, Sports Traumatol, Arthros: Off J ESSKA. https://doi.org/10.1007/s00167-019-05590-4

    Article  Google Scholar 

  16. Okazaki Y, Furumatsu T, Okazaki Y, Masuda S, Hiranaka T, Kodama Y, Kamatsuki Y, Miyazawa S, Tetsunaga T, Ozaki T (2020) Medial meniscus posterior root repair decreases posteromedial extrusion of the medial meniscus during knee flexion. Knee 27(1):132–139. https://doi.org/10.1016/j.knee.2019.09.005

    Article  PubMed  Google Scholar 

  17. Okazaki Y, Furumatsu T, Yamaguchi T, Kodama Y, Kamatsuki Y, Masuda S, Okazaki Y, Hiranaka T, Zhang X, Ozaki T (2020) Medial meniscus posterior root tear causes swelling of the medial meniscus and expansion of the extruded meniscus: a comparative analysis between 2D and 3D MRI. Knee Surg, Sports Traumatol, Arthros: Off J ESSKA 28(11):3405–3415. https://doi.org/10.1007/s00167-019-05580-6

    Article  Google Scholar 

  18. Chang EY, Chen KC, Chung CB (2014) The shiny corner of the knee: a sign of meniscal osteochondral unit dysfunction. Skeletal Radiol 43(10):1403–1409. https://doi.org/10.1007/s00256-014-1958-7

    Article  PubMed  Google Scholar 

  19. LaPrade CM, James EW, Cram TR, Feagin JA, Engebretsen L, LaPrade RF (2015) Meniscal root tears: a classification system based on tear morphology. Am J Sports Med 43(2):363–369. https://doi.org/10.1177/0363546514559684

    Article  PubMed  Google Scholar 

  20. Son JY, Yoon YC, Jin W, Cha JG (2018) The prevalence and characteristics of a subcortical cystic lesion at the subspinous region of the knee. Acta radiologica (Stockholm Sweden: 1987) 59(1): 97–104 https://doi.org/10.1177/0284185117703153

  21. Johannsen AM, Civitarese DM, Padalecki JR, Goldsmith MT, Wijdicks CA, LaPrade RF (2012) Qualitative and quantitative anatomic analysis of the posterior root attachments of the medial and lateral menisci. Am J Sports Med 40(10):2342–2347. https://doi.org/10.1177/0363546512457642

    Article  PubMed  Google Scholar 

  22. Lotke PA, Ecker ML (1988) Osteonecrosis of the knee. J Bone Joint Surg Am 70(3):470–473

    Article  CAS  Google Scholar 

  23. Asai K, Nakase J, Oshima T, Shimozaki K, Toyooka K, Tsuchiya H (2020) Lateral meniscus posterior root tear in anterior cruciate ligament injury can be detected using MRI-specific signs in combination but not individually. Knee Surg, Sports Traumatol, Arthrosc: Off J ESSKA 28(10):3094–3100. https://doi.org/10.1007/s00167-019-05599-9

    Article  Google Scholar 

  24. Furumatsu T, Kodama Y, Kamatsuki Y, Hino T, Okazaki Y, Ozaki T (2017) Meniscal extrusion progresses shortly after the medial meniscus posterior root tear. Knee Surg Relat Res 29(4):295–301. https://doi.org/10.5792/ksrr.17.027

    Article  PubMed  PubMed Central  Google Scholar 

  25. Okazaki Y, Furumatsu T, Shimamura Y, Saiga K, Ohashi H, Uchino T, Kamatsuki Y, Okazaki Y, Ozaki T (2019) Time-dependent increase in medial meniscus extrusion after medial meniscus posterior root tear analyzed by using magnetic resonance imaging. Knee Surg Relat Res. https://doi.org/10.5792/ksrr.18.059

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

We would like to thank Editage (www.editage.com) for English language editing.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Dentistry, and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan

    Yuki Okazaki, Takayuki Furumatsu, Yuya Kajiki, Takaaki Hiranaka, Keisuke Kintaka, Yuya Kodama, Yusuke Kamatsuki & Toshifumi Ozaki

  2. Department of Orthopaedic Surgery, Kosei Hospital, Okayama, Japan

    Yuki Okazaki

  3. Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, USA

    Yuya Kodama

Authors
  1. Yuki Okazaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Takayuki Furumatsu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yuya Kajiki
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Takaaki Hiranaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Keisuke Kintaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yuya Kodama
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Yusuke Kamatsuki
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Toshifumi Ozaki
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Takayuki Furumatsu designed the study. Yuki Okazaki and Yuya Kajiki contributed to the analysis and interpretation of data. All authors contributed to data collection and interpretation, and critically reviewed the manuscript. All authors approved the final version of the manuscript and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Takayuki Furumatsu.

Ethics declarations

Conflict of interest

The authors have no conflicts of interest to declare that are relevant to the content of this article.

Availability of data and material

Not applicable.

Code availability

Not applicable.

Ethics approval

This study and all protocols were approved by our institutional ethics review board.

Consent to participate

All patients provided informed consent to participate in this study.

Consent for publication

All participants provided informed consent for the publication of this study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Okazaki, Y., Furumatsu, T., Kajiki, Y. et al. A posterior shiny-corner lesion of the tibia is observed in the early phase after medial meniscus posterior root tear. Eur J Orthop Surg Traumatol 32, 301–306 (2022). https://doi.org/10.1007/s00590-021-02968-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00590-021-02968-4

Keywords

Search

Navigation