A Larger Radius of the Medial Femoral Posterior Condyle is a Risk Factor for Medial Meniscus Posterior Root Tears

Overview

Journal BMC Musculoskelet Disord

Publisher Biomed Central

Specialties Orthopedics
Physiology

Date 2024 Aug 1

PMID 39090595

Authors

Junsen Wang

Kangzu Peng

Juyuan Gu

Shijun Gao

Affiliations

Soon will be listed here.

Abstract

Background: Studies have shown an association between medial meniscus posterior root tears (MMPRT) and morphologic characteristics of the bone. However, the association between distal femoral bone morphology and MMPRT, particularly the medial femoral posterior condyle, is poorly understood. Our study aimed to determine the association between the morphologic characteristics of the medial posterior femoral condyle and MMPRT.

Methods: A retrospective case-control study was performed from January 2021 to January 2022. After screening based on the inclusion and exclusion criteria, two matched groups were analyzed: the MMPRT group and the isolated lateral meniscus tears group. The hip-knee-ankle angle (HKA) and Kellgren-Lawrence grade (KLG) were measured on radiographs; the medial tibial slope angle (MTSA), medial tibial plateau depth (MTPD), and radius of the medial femoral posterior condyle (RMFPC) were measured on magnetic resonance imaging (MRI) in both groups. The area under the curve (AUC) and the best cutoff value for predicting MMPRT were calculated by using receiver operating characteristic (ROC) curve analysis.

Results: The final analysis included a total of 174 patients (87 MMPRT patients and 87 controls). Significant differences were shown in the RMFPC (17.6 ± 1.0 vs. 16.2 ± 1.0, p < 0.01) and MTSA (6.4 ± 2.0 vs. 4.0 ± 1.3, p < 0.01), which were larger than those of the control group. The MTPD (1.8 ± 0.6 vs. 2.9 ± 0.7, p < 0.01) and HKA (175.4 ± 2.2 vs. 179.0 ± 2.7, p < 0.01) of the injury group were significantly different from the control group, and both were lower than the control group. However, between the MMPRT and control groups on the KLG (2.3 ± 0.6 vs. 2.2 ± 0.6, p = 0.209), there was no statistically significant difference. Among them, the RMFPC cutoff value was calculated to be 16.8 mm by ROC curve analysis, and the sensitivity and specificity were both 81.61%.

Conclusions: This study demonstrated that larger RMFPC, MTSA, smaller MTPD, and HKA were all associated with MMPRT, and RMFPC ≥ 16.8 mm was considered as a significant risk factor for MMPRT.

References

Flandry F, Hommel G . Normal anatomy and biomechanics of the knee. Sports Med Arthrosc Rev. 2011; 19(2):82-92. DOI: 10.1097/JSA.0b013e318210c0aa. View

Cox C, DeAngelis J, Magnussen R, Fitch R, Spindler K . Meniscal tears in athletes. J Surg Orthop Adv. 2009; 18(1):2-8. View

Suganuma J . Lack of posteromedial tibiofemoral congruence at full flexion as a causative factor in isolated medial meniscal tears. J Orthop Sci. 2002; 7(2):217-25. DOI: 10.1007/s007760200036. View

Mameri E, Dasari S, Fortier L, Verdejo F, Gursoy S, Yanke A . Review of Meniscus Anatomy and Biomechanics. Curr Rev Musculoskelet Med. 2022; 15(5):323-335. PMC: 9463428. DOI: 10.1007/s12178-022-09768-1. View

Benhenneda R, Alajji M, Portet A, Sonnery-Cottet B, Fayard J, Thaunat M . Repair of radial tears of the lateral meniscus on a stable knee: Results at a minimum follow-up of 2 years. Orthop Traumatol Surg Res. 2024; 110(4):103877. DOI: 10.1016/j.otsr.2024.103877. View

Granan L, Inacio M, Maletis G, Funahashi T, Engebretsen L . Sport-specific injury pattern recorded during anterior cruciate ligament reconstruction. Am J Sports Med. 2013; 41(12):2814-8. DOI: 10.1177/0363546513501791. View

Okazaki Y, Furumatsu T, Kodama Y, Kamatsuki Y, Okazaki Y, Hiranaka T . Steep posterior slope and shallow concave shape of the medial tibial plateau are risk factors for medial meniscus posterior root tears. Knee Surg Sports Traumatol Arthrosc. 2019; 29(1):44-50. DOI: 10.1007/s00167-019-05590-4. View

Ahmed A, Burke D . In-vitro measurement of static pressure distribution in synovial joints--Part I: Tibial surface of the knee. J Biomech Eng. 1983; 105(3):216-25. DOI: 10.1115/1.3138409. View

Shelburne K, Kim H, Sterett W, Pandy M . Effect of posterior tibial slope on knee biomechanics during functional activity. J Orthop Res. 2010; 29(2):223-31. DOI: 10.1002/jor.21242. View

10.

Iwaki H, Pinskerova V, Freeman M . Tibiofemoral movement 1: the shapes and relative movements of the femur and tibia in the unloaded cadaver knee. J Bone Joint Surg Br. 2000; 82(8):1189-95. DOI: 10.1302/0301-620x.82b8.10717. View

11.

Cooke T, Li J, Scudamore R . Radiographic assessment of bony contributions to knee deformity. Orthop Clin North Am. 1994; 25(3):387-93. View

12.

Suganuma J, Mochizuki R, Yamaguchi K, Inoue Y, Yamabe E, Ueda Y . Cam impingement of the posterior femoral condyle in medial meniscal tears. Arthroscopy. 2010; 26(2):173-83. DOI: 10.1016/j.arthro.2009.11.002. View

13.

Chung J, Song H, Jung M, Oh H, Kim J, Yoon J . Larger medial femoral to tibial condylar dimension may trigger posterior root tear of medial meniscus. Knee Surg Sports Traumatol Arthrosc. 2015; 24(5):1448-54. DOI: 10.1007/s00167-015-3618-4. View

14.

Agneskirchner J, Hurschler C, Stukenborg-Colsman C, Imhoff A, Lobenhoffer P . Effect of high tibial flexion osteotomy on cartilage pressure and joint kinematics: a biomechanical study in human cadaveric knees. Winner of the AGA-DonJoy Award 2004. Arch Orthop Trauma Surg. 2004; 124(9):575-84. DOI: 10.1007/s00402-004-0728-8. View

15.

Kang H . Sample size determination and power analysis using the G*Power software. J Educ Eval Health Prof. 2021; 18:17. PMC: 8441096. DOI: 10.3352/jeehp.2021.18.17. View

16.

Howell S, Howell S, Hull M . Assessment of the radii of the medial and lateral femoral condyles in varus and valgus knees with osteoarthritis. J Bone Joint Surg Am. 2010; 92(1):98-104. DOI: 10.2106/JBJS.H.01566. View

17.

Bozkurt M, Unlu S, Cay N, Apaydin N, Dogan M . The potential effect of anatomic relationship between the femur and the tibia on medial meniscus tears. Surg Radiol Anat. 2014; 36(8):741-6. DOI: 10.1007/s00276-014-1266-x. View

18.

LaPrade R, Ho C, James E, Crespo B, LaPrade C, Matheny L . Diagnostic accuracy of 3.0 T magnetic resonance imaging for the detection of meniscus posterior root pathology. Knee Surg Sports Traumatol Arthrosc. 2014; 23(1):152-7. DOI: 10.1007/s00167-014-3395-5. View

19.

Marouane H, Shirazi-Adl A, Hashemi J . Quantification of the role of tibial posterior slope in knee joint mechanics and ACL force in simulated gait. J Biomech. 2015; 48(10):1899-905. DOI: 10.1016/j.jbiomech.2015.04.017. View

20.

Bhatia S, LaPrade C, Ellman M, LaPrade R . Meniscal root tears: significance, diagnosis, and treatment. Am J Sports Med. 2014; 42(12):3016-30. DOI: 10.1177/0363546514524162. View