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. 2023 Oct;47(10):2537-2545.
doi: 10.1007/s00264-023-05848-0. Epub 2023 Jun 17.

Epidemiological features of acute medial meniscus posterior root tears

Yusuke Kamatsuki  1   2 , Takayuki Furumatsu  3 , Takaaki Hiranaka  1 , Yuki Okazaki  1 , Keisuke Kintaka  1 , Yuya Kodama  1 , Shinichi Miyazawa  1 , Toshifumi Ozaki  1
Affiliations

Epidemiological features of acute medial meniscus posterior root tears

Yusuke Kamatsuki et al. Int Orthop. 2023 Oct.

Abstract

Purpose: Untreated or overlooked medial meniscus posterior root tears (MMPRTs) induce sequential knee joint degradation. We evaluated epidemiological features of acute MMPRT for its early detection and accurate diagnosis.

Methods: Among 330 MMPRT patients from 2018 to 2020, those who underwent arthroscopic pullout repairs were enrolled. Patients who underwent non-operative treatment or knee arthroplasty, those with a cruciate ligament-deficient knee or advanced osteoarthritis of the knee, and those with insufficient data were excluded. Finally, we retrospectively evaluated data from 234 MMPRTs (female: 79.9%, complete tears: 92.7%, mean age: 65 years). Welch's t-test and Chi-squared test were used for pairwise comparisons. Spearman's rank correlation analysis was performed between age at surgery and body mass index (BMI). Multivariable logistic regression analysis with stepwise backward elimination was applied to the values as risk factors for painful popping events.

Results: In both sexes, there were significant differences in height, weight, and BMI. In all patients, there was a significant negative correlation between BMI and age (ρ = - 0.36, p < 0.001). The BMI cutoff value of 27.7 kg/m2 had a 79.2% sensitivity and a 76.9% specificity for detecting MMPRT patients aged < 50 years. A painful popping event was confirmed in 187 knees (79.9%), and the frequency was significantly reduced in partial tears as compared to complete tears (odds ratio: 0.080, p < 0.001).

Conclusion: Higher BMI was associated with a significantly younger age of MMPRT onset. Partial MMPRTs had a low frequency of painful popping events (43.8%).

Keywords: Body mass index; Medial meniscus; Painful popping; Posterior root tear; Pullout repair.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Flowchart of the study protocol. MMPRT, medial meniscus posterior root tear; TKA, total knee arthroplasty; UKA, unicompartmental knee arthroplasty; ACL, anterior cruciate ligament; PCL, posterior cruciate ligament
Fig. 2
Fig. 2
Patient distribution by age and body mass index (BMI). Black squares and bars represented (a) mean BMI ± standard deviation (SD) for several ages and (b) mean age ± SD for several BMIs
Fig. 3
Fig. 3
Correlation analysis of body mass index and age. (a) All knees. ρ =  − 0.36, p < 0.001. (b) Female knees. ρ =  − 0.34, p < 0.001. (c) Male knees. ρ =  − 0.34, p < 0.001. ρ, Spearman’s rank correlation coefficient
Fig. 4
Fig. 4
The optimal cutoff value for body mass index (BMI) to detect MMPRT patients under 50 years of age. The BMI cutoff value of 27.7 kg/m2 had a 79.2% sensitivity and a 76.9% specificity for MMPRT detection in patients under 50 years of age. AUC, area under the curve; CI, confidence interval; MMPRT, medial meniscus posterior root tear
Fig. 5
Fig. 5
Distribution of injury patterns by (a) sex and (b) type of medial meniscus posterior root tear
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