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Document Title: Choi-AJARS-May06.shtml
Article Title: Anterior Horn Tears of the Lateral Meniscus in Soccer Players
Authors: Nam-Hong Choi M.D. and Brian N. Victoroff M.D.
Publication: Arthroscopy: The Journal of Arthroscopic and Related Surgery
Date: May 2006
Volume 22, Issue 5 , May 2006, Pages 484-488
Keywords: Lateral meniscus, anterior horn, soccer injuries, planting and twisting, cutting-type injuries, combination compression and twisting of knee.
(Reference-denoting numbers appear in the same font and point size as the document text. As with all Knee Library documents, this article is provided in full-text form, complete with all figures and tables.)
Comments: This very insightful study shows that the McMurray test and joint-line tenderness are not definitive when examining a knee for meniscal tears. MRI scans, which are extremely valuable for assessing meniscal damage, should be used too. (As for the manual-manipulation tests, note that other meniscal tests should also be in the orthopedist's toolbox, most notably Ege's test, as described in Akseki-AJARS-Nov04.shtml.) The authors note that longitudinal tears tend to be common in soccer players; in fact, such tears are probably common in all players of planting-and-twisting (also known as cutting-type or pivoting-type) sports.
Abstract
Purpose: The purpose of this retrospective study was to define the clinical and arthroscopic characteristics of anterior horn tears of the lateral meniscus.
Type of Study: Case series.
Methods: Fourteen patients with mean age of 20.2 years were enrolled in this institutional review board–approved study. All patients were soccer players with tears of the anterior horn of the lateral meniscus. All patients underwent physical examinations, magnetic resonance imaging (MRI), and arthroscopic treatment.
Results: Common symptoms were a catching sensation in 10 patients (71.4%), pain at squatting in 9 patients (64.3%), and sense of giving way and effusion, each in 7 patients (50%). Five patients (35.7%) had lateral joint-line tenderness. McMurray’s test was positive in 6 (42.9%) and tears were diagnosed by MRI in 13 (92.8%) patients. Arthroscopic examination showed multiple longitudinal tears in the avascular white zone of the meniscus in 7 patients (50%).
Conclusions: These data show that the McMurray test and joint-line tenderness had a low diagnostic value in diagnosing anterior horn tears of the lateral meniscus. MRI, however, had a high diagnostic value. Common arthroscopic findings included multiple longitudinal tears within the white zone of the anterior horn. Level of Evidence: Level IV.
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