(a) The anterior horn of the medial meniscus was detached and the anterior tibial surface was exposed (black arrow). A torn meniscus causes pain, swelling and stiffness. Root tears of the medial meniscus are being recognized on an MRI with increasing frequency. [4] obtained satisfactory results of 15 dislocations of the anterior horn of the medial meniscus without any surgical treatments. These findings on preoperative MRI of the knee were initially interpreted as a parameniscal cyst. Posterior horn of medial meniscus is the primary weight-bearing component of the medial meniscus, so it is also a common site of tearing or injuries. 18 reported that in females, higher BMI, greater varus mechanical axis angle and lower sports activity level are intrinsic risk … Magnetic resonance images of the right knee showed a cystic lesion adjacent to the anterior horn of the medial meniscus (Figure 1). No abnormal signals adjacent to the anterior horn of the medial meniscus were noted on magnetic resonance images at 12 months postoperatively. The absent anterior insertion to the tibia induces abnormal mobility in the anterior horn and may cause anterior knee pain. The anterior one-third of the meniscus was hypermobile and was displaced below the medial tibial plateau with the knee flexed about 45 degrees (Figure 2(b)). The patient was followed up regularly. Shoji Fukuta, Takahiko Tsutsui, Tetsuya Matsuura, Naoto Suzue, Daisuke Hamada, Tomohiro Goto, Koichi Sairyo, "Detached Anterior Horn of the Medial Meniscus Mimicking a Parameniscal Cyst", Case Reports in Orthopedics, vol. The lateral meniscus is on the outside of the knee. White arrows indicate the lesion. There is no popliteal cyst. The anterior horn of the medial meniscus is normally attached to the anterior surface of the tibia; however, several anatomic variations of this attachment have been reported [5, 6]. In this study, anterior knee pain syndrome was diagnosed in 12 (11.7%) of the 103 VAMM knees. Damage to secondary supporting structures such as the transverse ligament may also increase instability of the medial meniscus. Of note, a new study in the Orthopaedic Journal of Sports Medicine examined different surgical techniques for meniscus radial tears. They may also feel pain with full flexion of the knee and have a positive McMurray test after visiting an orthopaedic surgeon. Over 70% of tears occur in the posterior horns. They act as shock absorbers and stabilize the knee. (A) The AMMFL (black arrow) originated from the anterior horn of the medial meniscus and continued as band-like tissue to the posterolateral wall of the femur. The meniscus is broken down into the outer, middle, and inner thirds. After refreshing the original footprint of the anterior horn on the anterior tibia using a motorized shaver, a bioabsorbable suture anchor single-loaded with nonabsorbable suture (Panalok Loop, Depuy-Mitek, Norwood, MA) was inserted through the regular medial portal. Boucher [2] reported that 34 knees had strain or rupture of the anterior marginal attachment in 350 knee arthrotomies for suspected internal derangement; however, he did not comment on treatment for this injury. Conservative treatment — such as rest, ice and medication — is sometimes enough to relieve the pain of a torn meniscus and give the injury time to heal on its own. Symptomatic unstable anterior horn of the medial meniscus was first mentioned by Jones [1] in 1925. The anterior horn has an insertion on the tibia and a second portion that travels from medial to lateral to connect to the anterior horn of the lateral meniscus (intermeniscal or transverse ligament). A medial meniscus tear is an injury characterized by tearing of cartilage tissue located at the inner aspect of the knee and typically causes pain in this region. It is believed that only about 10% of patients with injuries resulting in Posterior Horn Medial Meniscus Tear are completely repairable. The semilunar-shaped medial and lateral fibrocartilage menisci have a concave superior surface that contours to the shape of the large convex femoral condyles(1-3), and a flat inferior tibial surface that articulates with the flat tibial plateau. Furthermore, the anterior horn of the medial meniscus is often covered with a synovial tissue and may be missed during routine arthroscopic examination. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Anterior horn/root with simple planar insertions into the [5] The main aim of treatment is to slow down the disease process and avoid complications like osteoarthritis. This is because the medial meniscus acts as a secondary stabilizer to restrict the knee from slipping forward, and when the ACL tear, it gives extra stress on the medial meniscus which prompts to it tearing. The menisci — the medial meniscus and lateral meniscus - are crescent-shaped bands of thick, rubbery cartilage attached to the shinbone (tibia). 7 Finally, the meniscus has a role in joint lubrication. A 34-year-old woman presented with a 3-month history of pain in the left knee with no history of trauma. The meniscus (especially the posterior horn of the medial meniscus) can be a secondary stabilizer in an ACL deficient knee. Most of the time, rest, ice, and pain meds are enough to help you feel better. Preoperative magnetic resonance images of the knee were initially interpreted as a parameniscal cyst. These commonly result when the knee is injured during blunt trauma but a sudden knee jerk or twist can result in just the same. Longitudinal (vertical) tear of the anterior horn, body and posterior horn medial meniscus without complete extrusion or parameniscal cyst formation. On plain radiographs no degenerative changes were visible in the medial compartment. incidence of medial meniscal tearing. Arthroscopic repair of the anterior horn of the medial meniscus is more feasible than partial meniscectomy. In their series, however, only 2 of 15 knees had isolated lesions and the other 13 had associated lesions. Over exerting the knees during exercise can also cause tears in the meniscus. Lesions of the medial meniscus are most frequently seen on the posterior portion of the meniscal body so that little attention may be paid to the anterior horn. Posterior Horn Meniscus Tear The meniscus is a C-shaped cartilage disk that is found in the knee. We use cookies to help provide and enhance our service and tailor content and ads. This tear pattern occurs seven times more frequently in the MM and has at least five different MR imaging signs: an absent bow tie, a fragment within the intercondylar notch, a double PCL, a double anterior horn or flipped meniscus, and a disproportionally small posterior horn … Collagen fibers are later organized in a transverse and circumferential fashion. A handful of you had a significant sports-related injury or ACL tear and find that you also have a root tear. If it is missing on the sagittal images, then there is a meniscal root tear (figure). We have the medial meniscus on the inner side of the knee and the lateral meniscus on the outer side of the knee. A posterior horn tear is the most common. There was no tear in the medial meniscus and only grade I degeneration at the anterior horn. Each limb of the suture was passed through the meniscus by a suture passer. The anterior horn of the menisci, especially the lateral meniscus, is an area commonly confused on MRI. flex the knee and place a hand on medial side of knee, externally rotate the leg and bring the knee into extension. No signal abnormalities were found in the body of the medial meniscus or in other structures. No bone marrow edema. [3] described the cases of 13 patients with symptomatic dislocation of the anterior horn of the medial meniscus. The arthroscopic findings indicated that the anterior horn of the medial meniscus was not attached directly to the tibia in any of these knees. Arthroscopic views. The wall of the cyst related to the anterior horn of the medial meniscus was detected and excised with a punch. Imaging. A tear of a meniscus is a rupturing of one or more of the fibrocartilage strips in the knee called menisci.When doctors and patients refer to "torn cartilage" in the knee, they actually may be referring to an injury to a meniscus at the top of one of the tibiae.Menisci can be torn during innocuous activities such as walking or squatting.
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