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Knee

Understanding Meniscus Root Tears

: Causes and Management Introduction The meniscus plays a role in the distribution of tibiofemoral forces, joint congruency, and shock absorption (6, 7).

G
Greg Rubin
Sports Medicine Physician ยท September 18, 2022 ยท 3 min read

Overview

: Causes and Management The meniscus plays a role in the distribution of tibiofemoral forces, joint congruency, and shock absorption (6, 7). There are other ligamentous supports of the meniscus that go beyond the scope of this review including the menisotibial ligaments, popliteomeniscal fascicles, meniscofibular ligaments, and meniscofemoral ligaments. The main goal of the meniscus root is to prevent meniscus extrusion so that the meniscus can continue to decrease load to the articular cartilage.

Symptoms

When an axial load acts upon the joint, it directs forces towards the outside of the joint and then there is a counter tensile stress (AKA hoop stress) by the meniscus to resist this force and distribute forces evenly across the joint surface. The loss of hoop stress of the meniscus can lead to the development of osteoarthritis. Injuries to the meniscus root can be acute or chronic.

Causes and Risk Factors

Root tears have been identified in 4.3% of all arthroscopic knee surgeries and over half have been of the posterior meniscus root. Acute medial meniscus root tears are seen in young athletes with a hyperextension mechanism. Acute on chronic medial meniscus root tears are found in moderate osteoarthritis.

Treatment Options

The anterior horn of the medial meniscus root inserts on the intercondylar crest and has a larger area of insertion than the anterior horn of the lateral meniscus. As a result of the larger area of insertion and thicker root, the anterior roots can withstand greater forces than the posterior roots. One of the most common roots injured is the posterior medial meniscus root ligament (PMMRL).

Recovery

The insertion of the PMMRL is between the posterior cruciate ligament and the posterior root of the lateral meniscus. Injures to the PMMRL are associated with higher rates of total knee arthroplasty. Imaging of the Posterior Medial Meniscus Root Diagnosis There is no physical exam test that accurately identified meniscus root tears.

When to See a Doctor

If you are experiencing symptoms that may be related to meniscus root tears, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.

*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*

Knee
G
Greg Rubin
Sports Medicine Physician
Sports Medicine Review contributor

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