Document Title: Metcalf-AJSM-Apr04.shtml
Article Title: Prospective Evaluation of 1485 Meniscal Tear Patterns in Patients With Stable Knees
Authors: Michael H. Metcalf, MD and Gene R. Barrett, MD
Publication: American Journal of Sports Medicine, Baltimore, Maryland
Date: April 2004
Volume 32, pages 675-680
Keywords: meniscal damage, ACL deficiency, osteoarthritis

(Figures included. Reference-denoting numbers appear in the same point size as the document text.)

This thought-provoking study reveals that whether or not the knee is stable has a substantial impact on the types of meniscal injuries that can be expected. Albeit meniscal damage can occur in the absence of ligamentous problems, complete ACL tearing (if unaddressed and if allowed to remain chronic, and especially if the knee is permitted to give way subsequent to the original injury incident) is a sure-fire way harbinger of abnormally rapid meniscal erosion and ensuing osteoarthritis. If an knee harbouring a torn meniscus is unstable due to the presence of a fully torn ACL, then the best treatment route is to promptly have the ACL reconstructed and also to have the meniscal tear repaired (preferably via cross-suturing or similar method).

Abstract

Background: Despite emphasis on classifying meniscal tears based on healing potential of the tear, research has concentrated on unstable knees, and few reports have provided information regarding associated clinical variables in stable knees.

Purpose: To report on a large series of meniscal tears in stable knees that have been carefully mapped by tear shape and tear zones to allow comparison with meniscal tears in unstable knees.

Study Design: Prospective case series, reviewed retrospectively.

Methods: A total of 1485 meniscal tears in stable knees were evaluated. Preoperatively, each patient underwent a standardized assessment. Each tear was carefully mapped at arthroscopy. Statistical analysis was performed to determine factors that may be associated with peripheral meniscal tears.

Results: The distribution and shape of tears varied significantly within the radial and circumferential zones in this stable knee population. Five prospective variables were associated with peripheral tears: gender, presence of an effusion, positive McMurray test, varus alignment, or a loss of extension more than 5°.

Conclusions: Patient demographic information and physical examination can be useful in identifying patients who may have a peripheral meniscus tear.

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