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Traumatic and Degenerative Meniscus Lesions: Diagnosis and Classification

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Arthroscopy

Abstract

Injury of the knee joint meniscus is one of the most prevalent injuries in the human body. The prevalence of an acute meniscal injury has been estimated of being 60 out of 100,000 patients. Analysis of 19,530 sports injuries over a 10-year period showed knee involvement in 39.8 %. Anterior cruciate ligament (ACL) injuries occurred in 20.3 %, while medial and lateral meniscus lesions in 10.8 % and 3.7 % respectively [1].

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References

  1. Majewski M, Susanne H, Klaus S. Epidemiology of athletic knee injuries: a 10-year study. Knee. 2006;13:184–8.

    Article  CAS  PubMed  Google Scholar 

  2. Bellabarba C, Bush-Joseph CA, Bach Jr BR. Patterns of meniscal injury in the anterior cruciate-deficient knee: a review of the literature. Am J Orthop. 1997;26:18–23.

    CAS  PubMed  Google Scholar 

  3. Allen CR, Wong EK, Livesay GA, Sakane M, Fu FH, Woo SL. Importance of the medial meniscus in the anterior cruciate ligament-deficient knee. J Orthop Res. 2000;18:109–15.

    Article  CAS  PubMed  Google Scholar 

  4. Michalitsis S, Vlychou M, Malizos KN, et al. Meniscal and articular cartilage lesions in the anterior cruciate ligament-deficient knee: correlation between time from injury and knee scores. Knee Surg Sports Traumatol Arthrosc. 2015;23(1):232–9. doi:10.1007/s00167-013-2497-9.

    Article  PubMed  Google Scholar 

  5. Lee J, Fu F. The meniscus: basic science and clinical applications. Oper Tech Orthop. 2000;10:162–8.

    Article  Google Scholar 

  6. Lento P, Akuthota V. Meniscal injuries: a critical review. J Back Musculoskelet Rehabil. 2000;15:55–62.

    CAS  PubMed  Google Scholar 

  7. Kawamura S, Lotito K, Rodeo S. Biomechanics and healing response of the meniscus. Oper Tech Sports Med. 2003;11:68–76.

    Article  Google Scholar 

  8. Muellner T, Weinstable R, Schabus R, et al. The diagnosis of meniscal tears in athletes. Am J Sports Med. 1997;25(1):7–12.

    Article  CAS  PubMed  Google Scholar 

  9. McDermott I. Meniscal tears. Curr Orthop. 2006;20:85–94.

    Article  Google Scholar 

  10. Poehling GG, Ruch DS, Chabon SJ. The landscape of meniscal injuries. Clin Sports Med. 1990;9:539–49.

    CAS  PubMed  Google Scholar 

  11. Vanhoenacker FM, Maas M, Gielen J l. Imaging of orthopedic sports injuries (medical radiology/diagnostic imaging). Berlin: Springer; 2006. ISBN 3-540-26014-5.

    Google Scholar 

  12. Johnson GO, Starkey C. Athletic training and sports medicine. Boston: Jones and Bartlett Publishers; 2005. ISBN 0-7637-0536-5.

    Google Scholar 

  13. Vlychou M, Hantes M, Michalitsis S, et al. Chronic anterior cruciate ligament tears and associated meniscal and traumatic cartilage lesions: evaluation with morphological sequences at 3.0 T. Skeletal Radiol. 2011;40(6):709–16. doi:10.1007/s00256-010-1054-6. Epub 2010 Oct 27.

    Article  PubMed  Google Scholar 

  14. Ford GM, Hegmann KT, White Jr GL, et al. Associations of body mass index with meniscal tears. Am J Prev Med. 2005;28(4):364–8.

    Article  PubMed  Google Scholar 

  15. Schraeder TL, Terek RM, Smith CC. Clinical evaluation of the knee. N Eng J Med. 2010;363(4):e5.

    Article  CAS  Google Scholar 

  16. Malanga GA, Andrus S, Nadler SF, et al. Physical examination of the knee: a review of the original test description and scientific validity of common orthopedic tests. Arch Phys Med Rehabil. 2003;84:592–603.

    Article  PubMed  Google Scholar 

  17. Van Eck CF, Van den Bekerom MP, Fu FH, et al. Methods to diagnose acute anterior cruciate ligament rupture: a meta-analysis of physical examinations with and without anaesthesia. Knee Surg Sports Traumatol Arthrosc. 2013;21(8):1895–903.

    Article  PubMed  Google Scholar 

  18. Katz JW, Fingeroth RJ. The diagnostic accuracy of ruptures of the anterior cruciate ligament comparing the Lachman test, the anterior drawer sign, and the pivot shift test in acute and chronic knee injuries. Am J Sports Med. 1986;14:88–91.

    Article  CAS  PubMed  Google Scholar 

  19. Anderson AF, Lipscomb AB. Clinical diagnosis of meniscal tears. Description of a new manipulative test. Am J Sports Med. 1986;14:291–3.

    Article  CAS  PubMed  Google Scholar 

  20. Fowler PJ, Lubliner JA. The predictive value of five clinical signs in the evaluation of meniscal pathology. Arthroscopy. 1989;5:184–6.

    Article  CAS  PubMed  Google Scholar 

  21. Kurosaka M, Yagi M, Yoshiya S, et al. Efficacy of the axially loaded pivot shift test for the diagnosis of a meniscal tear. Int Orthop. 1999;23:271–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. McMurray T. The semilunar cartilages. Br J Surg. 1942;29:407–14.

    Article  Google Scholar 

  23. Evans PJ, Bell GD, Frank C. Prospective evaluation of the McMurray test. Am J Sport Med. 1993;21:604–8.

    Article  CAS  Google Scholar 

  24. Apley A. The diagnosis of meniscus injuries. J Bone Joint Surg. 1947;29:78–84.

    CAS  PubMed  Google Scholar 

  25. O’Shea KJ, et al. The diagnostic accuracy of history, physical examination, and radiographs in the evaluation of traumatic knee disorders. Am J Sports Med. 1996;24(2):164–7.

    Article  PubMed  Google Scholar 

  26. Karachalios T, Hantes M, Zibis, et al. Diagnostic accuracy of a new clinical test (the Thessaly test) for early detection of meniscal tears. J Bone Joint Surg. 2005;87(5):955–62.

    Article  PubMed  Google Scholar 

  27. Lowery DJ, Farley TD, Wing DW, Sterett WI, Steadman JR. A clinical composite score accurately detects meniscal pathology. Arthroscopy. 2006;22(11):1174–9.

    Article  PubMed  Google Scholar 

  28. Meserve BB, Cleland JA, Bocher TR. A meta-analysis examining clinical test utilities for assessing meniscal injury. Clin Rehabil. 2008;22(2):143–61.

    Article  PubMed  Google Scholar 

  29. Ryzewicz M, Peterson B, Siparsky PN, Bartz RL. The diagnosis of meniscal tears. The role of MRI and clinical examination. Clin Orthop Relat Res. 2007;445:123–33.

    Article  Google Scholar 

  30. Railhac JJ, Fournie A, Gay R, et al. A radiologic study of the knee in an antero-posterior incidence with light flexion and standing up position. Its interest in the diagnosis of femoro-tibial osteoarthrosis [author’s transl]. J Radiol. 1981;62:157–66.

    CAS  PubMed  Google Scholar 

  31. Rosenberg TD, Paulos LE, Parker RD, et al. The forty-five-degree posteroanterior flexion weight-bearing radiograph of the knee. J Bone Joint Surg Am. 1988;70:1479–83.

    CAS  PubMed  Google Scholar 

  32. Helms CA. The meniscus: recent advances in MR imaging of the knee. AJR Am J Roentgenol. 2002;179:1115–22.

    Article  PubMed  Google Scholar 

  33. Behairy NH, Dorgham MA, Khaled SA. Accuracy of routine magnetic resonance imaging in meniscal and ligamentous injuries of the knee: comparison with arthroscopy. Int Orthop. 2009;33(4):961–7.

    Google Scholar 

  34. Nikolaou VS, Chronopoulos E, Savvidou C, et al. MRI efficacy in diagnosing internal lesions of the knee: a retrospective analysis. J Trauma Manag Outcomes. 2008;2(1):4.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Ryzewicz M, Peterson B, Siparsky PN, Bartz RL. The diagnosis of meniscus tears: the role of MRI and clinical examination. Clin Orthop Relat Res. 2007;455:123–33.

    Article  PubMed  Google Scholar 

  36. Chambers S, Cooney A, Caplan N, et al. The accuracy of magnetic resonance imaging (MRI) in detecting meniscal pathology. R Nav Med Serv. 2007;100(2):157–60.

    Google Scholar 

  37. Crawford R, Walley G, Bridgman S, et al. Magnetic resonance imaging versus arthroscopy in the diagnosis of knee pathology, concentrating on meniscal lesions and ACL tears: a systematic review. Med Bull. 2007;84:5–23.

    Article  Google Scholar 

  38. White LM, Schweitzer ME, Weishaupt D, et al. Diagnosis of recurrent meniscal tears: prospective evaluation of conventional MR imaging, indirect MR arthrography, and direct MR arthrography. Radiology. 2002;222:421–9.

    Article  PubMed  Google Scholar 

  39. Crues III JV, Mink J, Levy TL, et al. Meniscal tears of the knee: accuracy of MR imaging. Radiology. 1987;164:445–8.

    Article  PubMed  Google Scholar 

  40. Dillon EH, Pope CF, Jokl P, et al. The clinical significance of stage 2 meniscal abnormalities on magnetic resonance knee images. Magn Reson Imaging. 1990;8(4):411 5.

    Article  CAS  PubMed  Google Scholar 

  41. Manco LG, Berlow ME. Meniscal tears–comparison of arthrography, CT, and MRI. Crit Rev Diagn Imaging. 1989;29:151–79.

    CAS  PubMed  Google Scholar 

  42. Manco LG, Kavanaugh JH, Fay JJ, et al. Meniscus tears of the knee: prospective evaluation with CT. Radiology. 1986;159:147–51.

    Article  CAS  PubMed  Google Scholar 

  43. Vande Berg BC, Lecouvet FE, Poilvache P, et al. Assessment of knee cartilage in cadavers with dual-detector spiral CT arthrography and MR imaging. Radiology. 2002;222:430–6.

    Article  PubMed  Google Scholar 

  44. Vande Berg BC, Lecouvet FE, Poilvache P, et al. Dual-detector spiral CT arthrography of the knee: accuracy for detection of meniscal abnormalities and unstable meniscal tears. Radiology. 2000;216:851–7.

    Article  CAS  PubMed  Google Scholar 

  45. Vande Berg BC, Lecouvet FE, Poilvache P, et al. Anterior cruciate ligament tears and associated meniscal lesions: assessment at dual-detector spiral CT arthrography. Radiology. 2002;223:403–9.

    Article  PubMed  Google Scholar 

  46. Lee W, Kim HS, Kim SJ, Kim HH, et al. CT arthrography and virtual arthroscopy in the diagnosis of the anterior cruciate ligament and meniscal abnormalities of the knee joint. Korean J Radiol. 2004;5(1):47–54.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Jakobson BW (2007) Meniscal injuries. ISAKOS/ ESSKA standard terminology, definitions, classification and scoring systems for arthroscopy: knee, shoul- der and ankle joint. ISAKOS/ESSKA, http://www.esska.org/upload/pdf/Standard_Terminology.pdf.

  48. Anderson AF, Irrgang JJ, Dunn W, et al. Interobserver reliability of the International Society of Arthroscopy. Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) classification of meniscal tears. Am J Sports Med. 2011;39(5):926–32.

    Article  PubMed  Google Scholar 

  49. Arnoczky SP, Warren RF. Miscrovasculature of the human meniscus. Am J Sports Med. 1982;10:90–5.

    Article  CAS  PubMed  Google Scholar 

  50. Arnoczky SP, Warren RF. The microvasculature of the meniscus and its response to injury: an experimental study in the dog. Am J Sports Med. 1983;11:131–41.

    Article  CAS  PubMed  Google Scholar 

  51. Cooper DE, Arnoczky SP, Warren RF. Meniscal repair. Clin Sports Med. 1991;10:529–48.

    CAS  PubMed  Google Scholar 

  52. Dunn W, Wolf B, Amendola A, et al. Multicenter agreement of arthroscopic meniscal lesions. Am J Sports Med. 2004;32:1937–43.

    Article  PubMed  Google Scholar 

  53. Smith 3rd JP, Barrett GR. Medial and lateral meniscal tear patterns in anterior cruciate ligament-deficient knees. A prospective analysis of 575 tears. Am J Sports Med. 2001;29:415–9.

    PubMed  Google Scholar 

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Hantes, M., Raoulis, V., Becker, R. (2016). Traumatic and Degenerative Meniscus Lesions: Diagnosis and Classification. In: Randelli, P., Dejour, D., van Dijk, C., Denti, M., Seil, R. (eds) Arthroscopy. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-49376-2_7

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  • DOI: https://doi.org/10.1007/978-3-662-49376-2_7

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