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. 2024 Nov 1;12(11):23259671241283962.
doi: 10.1177/23259671241283962. eCollection 2024 Nov.

Diagnosis and Treatment Strategies of Meniscus Root Tears: A Scoping Review

Jose Rafael Garcia  1 , Salvador Gonzalez Ayala  1 , Felicitas Allende  1 , Enzo Mameri  2   3 , Monique Haynes  1 , Filippo Familiari  4 , Andrew G Geeslin  5 , Iain Murray  6   7 , Gilbert Moatshe  8 , Nikhil N Verma  1 , Robert F LaPrade  9 , Jorge Chahla  1
Affiliations

Diagnosis and Treatment Strategies of Meniscus Root Tears: A Scoping Review

Jose Rafael Garcia et al. Orthop J Sports Med. .

Abstract

Background: Meniscus root tears comprise 10% to 21% of all meniscal tears. These tears alter knee biomechanics, elevating contact pressure, akin to a meniscectomy. Consequently, they are linked to advanced joint degeneration and cartilage damage in the affected compartment.

Purpose: To systematically evaluate and relate the current literature describing the diagnosis and treatment strategies for meniscus root tears.

Study design: Scoping review; Level of evidence, 4.

Methods: This review was conducted following the guidelines of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) extension for scoping reviews. Inclusion criteria encompassed English-language clinical and preclinical research, technical notes, and narrative reviews on meniscus root tears. Exclusion criteria were studies on patellar tendon rupture, studies on medial patellofemoral ligament rupture with additional knee joint ligament injuries, studies of patients <16 years old, and studies involving open fractures. The data were summarized using a descriptive analysis and a thematic analysis.

Results: After 1425 articles were identified, 461 studies were included; 17% (n = 78) were case reports or case series, 15% (n = 71) were technical notes, 9% (n = 41) addressed aspects of diagnosis, 7% (n = 32 ) were narrative reviews, and 5% (n = 21) were systematic reviews or meta-analyses. Studies presenting original data comprised 57% (n = 262) of all included studies, and 97% of the studies were of evidence levels 3 to 5. Contributions were mainly from the United States (n = 123; 27%), Republic of Korea (n = 102; 22%), and Japan (n = 99; 21%). Many studies (n = 216; 47%) focused on the treatment and outcomes of meniscus root tears. A significant chronological surge in the quantity of studies addressing the diagnosis and treatment of meniscus root tears was evident, particularly over the past 3 years. Consensus was found regarding the definition of meniscus root tears, the advantages of early repair, and postoperative rehabilitation protocols. The variations in surgical techniques and operative strategies created the greatest amount of contention, along with clinical assessment and imaging modalities.

Conclusion: High-level evidence studies for diagnosing and managing meniscus root tears were scarce. A consensus has yet to be reached regarding the role of concomitant osteotomy, comparison of repair techniques, the use of a centralization stitch, patient factors affecting outcomes, and long-term outcomes of nonoperative management.

Keywords: joint preservation; knee arthroscopy; meniscus; meniscus root; osteoarthritis.

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Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: A.G.G. has received education payments from Arthrex and nonconsulting fees from Ossur and Smith+Nephew. I.M. has received consulting fees from Arthrex and Stryker. N.N.V. has received research support from Breg and Ossur, consulting fees from Arthrex and Stryker, royalties from Graymont Professional Products and Smith+Nephew, and hospitality payments from Spinal Simplicity. R.F.L. has received research support from Linvatec and Ossur, education payments from Foundation Medical, consulting fees from Ossur, nonconsulting fees from ConMed and Smith+Nephew, and royalties from Arthrex and Ossur. J.C. has received grant support from Arthrex; education payments from Medwest Associates and Smith+Nephew; consulting fees from DePuy Synthes, RTI Surgical, Ossur, and Vericel; nonconsulting fees from Arthrex and CONMED; and hospitality payments from Stryker. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

Figures

Figure 1.
Figure 1.
Diagram demonstrating the article selection process conducted according to the 2020 PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines.
Figure 2.
Figure 2.
Bar graph demonstrating the number of studies related to meniscus root tear by publication year.
Figure 3.
Figure 3.
Heatmap of countries demonstrating geographic concentration of studies related to meniscus root tear.
Figure 4.
Figure 4.
Distribution of included studies according to level of evidence, as determined by the Journal of Bone and Joint Surgery ranking system.
Figure 5.
Figure 5.
Distribution of studies according to their primary focus.
Figure 6.
Figure 6.
The LaPrade classification for meniscus root tears using cadaveric specimens.
Figure 7.
Figure 7.
Magnetic resonance image of a left knee demonstrating (A) truncation, (B) ghost sign, (C) root tear, and (D) meniscal extrusion and bone marrow edema.
See this image and copyright information in PMC

References

    1. Aga C, Aasen IB, Brocker C, Kise NJ, Heir S. Lateral meniscal posterior root tears experience acceptable healing status after transtibial repair technique. J Exp Orthop. 2021;8(1):114. - PMC - PubMed
    1. Ahn JH, Jeong HJ, Lee YS, et al. Comparison between conservative treatment and arthroscopic pull-out repair of the medial meniscus root tear and analysis of prognostic factors for the determination of repair indication. Arch Orthop Trauma Surg. 2015;135(9):1265-1276. - PubMed
    1. Ahn JH, Lee YS, Chang JY, Chang MJ, Eun SS, Kim SM. Arthroscopic all inside repair of the lateral meniscus root tear. Knee. 2009;16(1):77-80. - PubMed
    1. Ahn JH, Lee YS, Yoo JC, Chang MJ, Park SJ, Pae YR. 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. - PubMed
    1. Akmese R, Malatyalı B, Kocaoglu H, Akkaya Z, Kalem M. A new clinical sign for diagnosing medial meniscus posterior root tear. Orthop J Sports Med. 2021;9(1):2325967120975511. - PMC - PubMed

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