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Meniscus Root Injury
Donna G. Blankenbaker, MD, FACR; Kirkland W. Davis, MD, FACR; Andrew Sonin, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Synonyms

                • Meniscus root avulsion, meniscus root tear, meniscus root ligament tear, posterior root tear
              • Definitions

                • Disruption of attachment site of meniscus to tibia, either anteriorly or, much more commonly, posteriorly

              IMAGING

              • General Features

                • CT Findings

                  • MR Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Gross Pathologic & Surgical Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        • Reporting Tips

                                          Selected References

                                          1. Jeon SW et al: Factors related to meniscal extrusion and cartilage lesions in medial meniscus root tears. J Knee Surg. 34(2):178-86, 2021
                                          2. Hoover KB et al: Reliability of meniscus tear description: a study using MRI from the osteoarthritis initiative. Rheumatol Int. 40(4):635-41, 2020
                                          3. Kennedy MI et al: Injury of the meniscus root. Clin Sports Med. 39(1):57-68, 2020
                                          4. Krych AJ et al: Medial vs. lateral meniscus root tears: is there a difference in injury presentation, treatment decisions, and surgical repair outcomes? Arthroscopy. 36(4):1135-41, 2020
                                          5. Chahla J et al: Meniscal root tears. Arthroscopy. 35(5):1304-5, 2019
                                          6. Furumatsu T et al: Injury patterns of medial meniscus posterior root tears. Orthop Traumatol Surg Res. 105(1):107-11, 2019
                                          7. Kim JY et al: A novel arthroscopic classification of degenerative medial meniscus posterior root tears based on the tear gap. Orthop J Sports Med. 7(3):2325967119827945, 2019
                                          8. Kosy JD et al: Meniscal root tears occur frequently in multi-ligament knee injury and can be predicted by associated MRI injury patterns. Knee Surg Sports Traumatol Arthrosc. 26(12):3731-7, 2018
                                          9. Bin SI et al: A new arthroscopic classification of degenerative medial meniscus root tear that correlates with meniscus extrusion on magnetic resonance imaging. Knee. 23(2):246-50, 2015
                                          10. Bonasia DE et al: Meniscal root tear repair: why, when and how? Orthop Rev (Pavia). 7(2):5792, 2015
                                          11. Chung JY et al: Larger medial femoral to tibial condylar dimension may trigger posterior root tear of medial meniscus. Knee Surg Sports Traumatol Arthrosc. 24(5):1448-54, 2015
                                          12. Feucht MJ et al: Arthroscopic transtibial pullout repair for posterior medial meniscus root tears: a systematic review of clinical, radiographic, and second-look arthroscopic results. Arthroscopy. 31(9):1808-16, 2015
                                          13. Feucht MJ et al: Associated tears of the lateral meniscus in anterior cruciate ligament injuries: risk factors for different tear patterns. J Orthop Surg Res. 10:34, 2015
                                          14. Geeslin AG et al: Influence of lateral meniscal posterior root avulsions and the meniscofemoral ligaments on tibiofemoral contact mechanics. Knee Surg Sports Traumatol Arthrosc. 24(5):1469-77, 2015
                                          15. LaPrade CM et al: Biomechanical consequences of a nonanatomic posterior medial meniscal root repair. Am J Sports Med. 43(4):912-20, 2015
                                          16. LaPrade CM et al: Meniscal root tears: a classification system based on tear morphology. Am J Sports Med. 43(2):363-9, 2015
                                          17. Mariani PP et al: Avulsion of both posterior meniscal roots associated with acute rupture of the anterior cruciate ligament. J Orthop Traumatol. 16(3):259-62, 2015
                                          18. Matheny LM et al: Posterior meniscus root tears: associated pathologies to assist as diagnostic tools. Knee Surg Sports Traumatol Arthrosc. 23(10):3127-31, 2015
                                          19. Shybut TB et al: Effect of lateral meniscal root tear on the stability of the anterior cruciate ligament-deficient knee. Am J Sports Med. 43(4):905-11, 2015
                                          20. Takahashi K et al: Medial meniscal posterior root/horn radial tears correlate with cartilage degeneration detected by T1ρ relaxation mapping. Eur J Radiol. 84(6):1098-104, 2015
                                          21. Bhatia S et al: Meniscal root tears: significance, diagnosis, and treatment. Am J Sports Med. 42(12):3016-30, 2014
                                          22. Choi JY et al: Posterior medial meniscus root ligament lesions: MRI classification and associated findings. AJR Am J Roentgenol. 203(6):1286-92, 2014
                                          23. Mohankumar R et al: Meniscal ossicle: posttraumatic origin and association with posterior meniscal root tears. AJR Am J Roentgenol. 203(5):1040-6, 2014
                                          24. Nguyen JC et al: MR imaging-based diagnosis and classification of meniscal tears. Radiographics. 34(4):981-99, 2014
                                          25. Umans H et al: Posterior horn medial meniscal root tear: the prequel. Skeletal Radiol. 43(6):775-80, 2014
                                          26. Casagranda BU et al: Coronal oblique imaging of the knee: can it increase radiologists' confidence in diagnosing posterior root meniscal tears? Clin Radiol. 68(6):e316-22, 2013
                                          27. Papalia R et al: Meniscal root tears: from basic science to ultimate surgery. Br Med Bull. 106:91-115, 2013
                                          28. Sung JH et al: Meniscal extrusion and spontaneous osteonecrosis with root tear of medial meniscus: comparison with horizontal tear. Arthroscopy. 29(4):726-32, 2013
                                          29. Choi SH et al: The MRI findings of meniscal root tear of the medial meniscus: emphasis on coronal, sagittal and axial images. Knee Surg Sports Traumatol Arthrosc. 20(10):2098-103, 2012
                                          30. Hwang BY et al: Risk factors for medial meniscus posterior root tear. Am J Sports Med. 40(7):1606-10, 2012
                                          31. Park HJ et al: Medial meniscal root tears and meniscal extrusion transverse length ratios on MRI. Br J Radiol. 85(1019):e1032-7, 2012
                                          32. Seil R et al: A clinical sign to detect root avulsions of the posterior horn of the medial meniscus. Knee Surg Sports Traumatol Arthrosc. 19(12):2072-5, 2011
                                          33. De Smet AA et al: MR diagnosis of posterior root tears of the lateral meniscus using arthroscopy as the reference standard. AJR Am J Roentgenol. 192(2):480-6, 2009
                                          34. Koenig JH et al: Meniscal root tears: diagnosis and treatment. Arthroscopy. 25(9):1025-32, 2009
                                          35. Robertson DD et al: Meniscal root injury and spontaneous osteonecrosis of the knee: an observation. J Bone Joint Surg Br. 91(2):190-5, 2009
                                          36. Lee SY et al: Radial tear of the medial meniscal root: reliability and accuracy of MRI for diagnosis. AJR Am J Roentgenol. 191(1):81-5, 2008
                                          37. Lee YG et al: Magnetic resonance imaging findings of surgically proven medial meniscus root tear: tear configuration and associated knee abnormalities. J Comput Assist Tomogr. 32(3):452-7, 2008
                                          38. Costa CR et al: Medial meniscus extrusion on knee MRI: is extent associated with severity of degeneration or type of tear? AJR Am J Roentgenol. 183(1):17-23, 2004
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Top Differential Diagnoses

                                                • Pathology

                                                  • Clinical Issues

                                                    • Diagnostic Checklist

                                                      TERMINOLOGY

                                                      • Synonyms

                                                        • Meniscus root avulsion, meniscus root tear, meniscus root ligament tear, posterior root tear
                                                      • Definitions

                                                        • Disruption of attachment site of meniscus to tibia, either anteriorly or, much more commonly, posteriorly

                                                      IMAGING

                                                      • General Features

                                                        • CT Findings

                                                          • MR Findings

                                                            • Imaging Recommendations

                                                              DIFFERENTIAL DIAGNOSIS

                                                                PATHOLOGY

                                                                • General Features

                                                                  • Gross Pathologic & Surgical Features

                                                                    CLINICAL ISSUES

                                                                    • Presentation

                                                                      • Demographics

                                                                        • Natural History & Prognosis

                                                                          • Treatment

                                                                            DIAGNOSTIC CHECKLIST

                                                                            • Consider

                                                                              • Image Interpretation Pearls

                                                                                • Reporting Tips

                                                                                  Selected References

                                                                                  1. Jeon SW et al: Factors related to meniscal extrusion and cartilage lesions in medial meniscus root tears. J Knee Surg. 34(2):178-86, 2021
                                                                                  2. Hoover KB et al: Reliability of meniscus tear description: a study using MRI from the osteoarthritis initiative. Rheumatol Int. 40(4):635-41, 2020
                                                                                  3. Kennedy MI et al: Injury of the meniscus root. Clin Sports Med. 39(1):57-68, 2020
                                                                                  4. Krych AJ et al: Medial vs. lateral meniscus root tears: is there a difference in injury presentation, treatment decisions, and surgical repair outcomes? Arthroscopy. 36(4):1135-41, 2020
                                                                                  5. Chahla J et al: Meniscal root tears. Arthroscopy. 35(5):1304-5, 2019
                                                                                  6. Furumatsu T et al: Injury patterns of medial meniscus posterior root tears. Orthop Traumatol Surg Res. 105(1):107-11, 2019
                                                                                  7. Kim JY et al: A novel arthroscopic classification of degenerative medial meniscus posterior root tears based on the tear gap. Orthop J Sports Med. 7(3):2325967119827945, 2019
                                                                                  8. Kosy JD et al: Meniscal root tears occur frequently in multi-ligament knee injury and can be predicted by associated MRI injury patterns. Knee Surg Sports Traumatol Arthrosc. 26(12):3731-7, 2018
                                                                                  9. Bin SI et al: A new arthroscopic classification of degenerative medial meniscus root tear that correlates with meniscus extrusion on magnetic resonance imaging. Knee. 23(2):246-50, 2015
                                                                                  10. Bonasia DE et al: Meniscal root tear repair: why, when and how? Orthop Rev (Pavia). 7(2):5792, 2015
                                                                                  11. Chung JY et al: Larger medial femoral to tibial condylar dimension may trigger posterior root tear of medial meniscus. Knee Surg Sports Traumatol Arthrosc. 24(5):1448-54, 2015
                                                                                  12. Feucht MJ et al: Arthroscopic transtibial pullout repair for posterior medial meniscus root tears: a systematic review of clinical, radiographic, and second-look arthroscopic results. Arthroscopy. 31(9):1808-16, 2015
                                                                                  13. Feucht MJ et al: Associated tears of the lateral meniscus in anterior cruciate ligament injuries: risk factors for different tear patterns. J Orthop Surg Res. 10:34, 2015
                                                                                  14. Geeslin AG et al: Influence of lateral meniscal posterior root avulsions and the meniscofemoral ligaments on tibiofemoral contact mechanics. Knee Surg Sports Traumatol Arthrosc. 24(5):1469-77, 2015
                                                                                  15. LaPrade CM et al: Biomechanical consequences of a nonanatomic posterior medial meniscal root repair. Am J Sports Med. 43(4):912-20, 2015
                                                                                  16. LaPrade CM et al: Meniscal root tears: a classification system based on tear morphology. Am J Sports Med. 43(2):363-9, 2015
                                                                                  17. Mariani PP et al: Avulsion of both posterior meniscal roots associated with acute rupture of the anterior cruciate ligament. J Orthop Traumatol. 16(3):259-62, 2015
                                                                                  18. Matheny LM et al: Posterior meniscus root tears: associated pathologies to assist as diagnostic tools. Knee Surg Sports Traumatol Arthrosc. 23(10):3127-31, 2015
                                                                                  19. Shybut TB et al: Effect of lateral meniscal root tear on the stability of the anterior cruciate ligament-deficient knee. Am J Sports Med. 43(4):905-11, 2015
                                                                                  20. Takahashi K et al: Medial meniscal posterior root/horn radial tears correlate with cartilage degeneration detected by T1ρ relaxation mapping. Eur J Radiol. 84(6):1098-104, 2015
                                                                                  21. Bhatia S et al: Meniscal root tears: significance, diagnosis, and treatment. Am J Sports Med. 42(12):3016-30, 2014
                                                                                  22. Choi JY et al: Posterior medial meniscus root ligament lesions: MRI classification and associated findings. AJR Am J Roentgenol. 203(6):1286-92, 2014
                                                                                  23. Mohankumar R et al: Meniscal ossicle: posttraumatic origin and association with posterior meniscal root tears. AJR Am J Roentgenol. 203(5):1040-6, 2014
                                                                                  24. Nguyen JC et al: MR imaging-based diagnosis and classification of meniscal tears. Radiographics. 34(4):981-99, 2014
                                                                                  25. Umans H et al: Posterior horn medial meniscal root tear: the prequel. Skeletal Radiol. 43(6):775-80, 2014
                                                                                  26. Casagranda BU et al: Coronal oblique imaging of the knee: can it increase radiologists' confidence in diagnosing posterior root meniscal tears? Clin Radiol. 68(6):e316-22, 2013
                                                                                  27. Papalia R et al: Meniscal root tears: from basic science to ultimate surgery. Br Med Bull. 106:91-115, 2013
                                                                                  28. Sung JH et al: Meniscal extrusion and spontaneous osteonecrosis with root tear of medial meniscus: comparison with horizontal tear. Arthroscopy. 29(4):726-32, 2013
                                                                                  29. Choi SH et al: The MRI findings of meniscal root tear of the medial meniscus: emphasis on coronal, sagittal and axial images. Knee Surg Sports Traumatol Arthrosc. 20(10):2098-103, 2012
                                                                                  30. Hwang BY et al: Risk factors for medial meniscus posterior root tear. Am J Sports Med. 40(7):1606-10, 2012
                                                                                  31. Park HJ et al: Medial meniscal root tears and meniscal extrusion transverse length ratios on MRI. Br J Radiol. 85(1019):e1032-7, 2012
                                                                                  32. Seil R et al: A clinical sign to detect root avulsions of the posterior horn of the medial meniscus. Knee Surg Sports Traumatol Arthrosc. 19(12):2072-5, 2011
                                                                                  33. De Smet AA et al: MR diagnosis of posterior root tears of the lateral meniscus using arthroscopy as the reference standard. AJR Am J Roentgenol. 192(2):480-6, 2009
                                                                                  34. Koenig JH et al: Meniscal root tears: diagnosis and treatment. Arthroscopy. 25(9):1025-32, 2009
                                                                                  35. Robertson DD et al: Meniscal root injury and spontaneous osteonecrosis of the knee: an observation. J Bone Joint Surg Br. 91(2):190-5, 2009
                                                                                  36. Lee SY et al: Radial tear of the medial meniscal root: reliability and accuracy of MRI for diagnosis. AJR Am J Roentgenol. 191(1):81-5, 2008
                                                                                  37. Lee YG et al: Magnetic resonance imaging findings of surgically proven medial meniscus root tear: tear configuration and associated knee abnormalities. J Comput Assist Tomogr. 32(3):452-7, 2008
                                                                                  38. Costa CR et al: Medial meniscus extrusion on knee MRI: is extent associated with severity of degeneration or type of tear? AJR Am J Roentgenol. 183(1):17-23, 2004