This retrospective observational study aims to investigate whether specific preoperative magnetic resonance imaging (MRI) and radiographic parameters are associated with medial meniscus posterior root tears (MMPRT), and whether these parameters have predictive value for mid-term clinical and radiographic outcomes after arthroscopic repair. Patients with arthroscopically confirmed MMPRT treated between 2020 and 2024 are evaluated based on their preoperative MRI and standing knee radiographs. Imaging parameters of interest include medial tibial slope, meniscal extrusion, tibial plateau depth, posterior root angle, and intercondylar notch morphology. Clinical outcomes are assessed using standardized scoring systems. The study aims to identify imaging-based anatomical risk factors to improve diagnosis, patient selection, and prognosis following MMPRT repair.
This retrospective observational study investigates the role of specific preoperative MRI and radiographic parameters in the diagnosis and prognosis of medial meniscus posterior root tears (MMPRT). Conducted at the Department of Orthopaedics and Traumatology, Karadeniz Technical University Farabi Hospital, the study aims to clarify whether morphologic imaging findings-such as medial tibial slope, meniscal extrusion, tibial plateau depth, posterior root angle, and intercondylar notch morphology-are associated with the presence of MMPRT and influence postoperative outcomes following arthroscopic repair. All imaging measurements were performed using standardized techniques on MRI and radiographs obtained prior to surgery. Parameters were assessed by two independent orthopedic surgeons on separate occasions to evaluate interobserver reliability. A matched control group of patients without meniscal pathology was formed to strengthen the comparative analysis and support the identification of risk factors. By analyzing a wide range of anatomic features on imaging, this study seeks to enhance early diagnostic accuracy, improve patient selection for surgical repair, and refine prognostic counseling. The findings are expected to contribute to the development of objective, imaging-based indicators that can guide clinical decision-making and predict mid-term clinical and radiographic outcomes after MMPRT repair.
Study Type
OBSERVATIONAL
Enrollment
128
Karadeniz Technical University, Orthopedic and Traumatology Department
Trabzon, Turkey (Türkiye)
Medial Tibial Slope
Measured in degrees (°) on sagittal MRI. It is the angle between the tangent to the medial tibial plateau and the anatomical axis of the proximal tibia, drawn using a line connecting the anterior and posterior cortices of the plateau.
Time frame: Preoperative MRI assessment
Medial Meniscus Extrusion
Measured in millimeters (mm) on coronal MRI. Defined as the distance from the outer margin of the medial meniscus to the edge of the tibial plateau
Time frame: Preoperative MRI assessment
Tibial Plateau Depth
Measured in millimeters (mm) on sagittal MRI. It is the perpendicular depth from the deepest point of the medial tibial plateau concavity to a reference line connecting the anterior and posterior cortical rims.
Time frame: Preoperative MRI assessment
Intercondylar Notch Width
Measured in millimeters (mm) on axial MRI images. Width of the intercondylar notch at the level of the popliteal groove.
Time frame: Preoperative MRI assessment
Intercondylar Distance
Measured in millimeters (mm) on axial MRI. The distance between the outer surfaces of the medial and lateral femoral condyles at the level of the intercondylar notch.
Time frame: Preoperative MRI assessment
Medial Femoral Condyle Angle
Measured in degrees (°) on sagittal MRI. It is the angle between the femoral anatomical axis and the curvature of the medial femoral condyle.
Time frame: Preoperative MRI assessment
Notch Width Index (ICNW/ICD Ratio)
A unitless ratio obtained by dividing the intercondylar notch width by the intercondylar distance on axial MRI at the level of the popliteal groove.
Time frame: Preoperative MRI assessment
Notch Shape
Morphological classification based on axial MRI. The intercondylar notch is categorized into A-type, U-type, or W-type based on its geometric configuration.
Time frame: Preoperative MRI assessment
Presence of Osteophyte (Spur)
Binary variable (Yes/No) indicating the presence of an osteophyte at the intercondylar notch on axial or sagittal MRI.
Time frame: Preoperative MRI assessment
Medial Femoral Condyle Width (MFCW)
Measured in millimeters (mm) on coronal MRI. The width of the medial tibial plateau at its maximum span.
Time frame: Preoperative MRI assessment
Medial Tibial Plateau Width (MTPW)
Measured in millimeters (mm) on coronal MRI. The width of the medial tibial plateau at its maximum span.
Time frame: Preoperative MRI assessment
MFCW/MTPW Ratio
Unitless ratio calculated by dividing medial femoral condyle width (MFCW) by medial tibial plateau width (MTPW) on coronal MRI.
Time frame: Preoperative MRI assessment
Medial Femoral Condyle Distal Offset Distance
Measured in millimeters (mm) on sagittal MRI at the level of the medial femoral condyle midpoint (defined on coronal MRI) as the perpendicular distance from the intercondylar axis to the most distal point of the condyle.
Time frame: Preoperative MRI
Medial Femoral Condyle Posterior Offset Distance
Measured in millimeters (mm) on the same sagittal MRI slice as the distal offset, defined as the distance from the intercondylar axis to the most posterior point of the condyle.
Time frame: Preoperative MRI
MFC Distal / Posterior Offset Ratio
A unitless ratio calculated by dividing the medial femoral condyle distal offset distance by its posterior offset distance on sagittal MRI.
Time frame: Preoperative MRI
International Knee Documentation Committee (IKDC) Score
Scored from 0 to 100, this subjective assessment evaluates knee symptoms, function, and ability to engage in sports activities. Higher scores indicate better outcomes.
Time frame: Preoperative and minimum 24-month postoperative follow-up
Lysholm Knee Score
Scored from 0 to 100, this questionnaire evaluates limping, support, locking, pain, swelling, stair climbing, and squatting. Higher scores indicate better knee function.
Time frame: Preoperative and minimum 24-month postoperative follow-up
Tegner Activity Scale
Activity level is rated on a scale from 0 (disability) to 10 (elite sports). Assesses the return to daily or sports-related physical activity.
Time frame: Preoperative and minimum 24-month postoperative follow-up
Kellgren-Lawrence Grade Progression
Graded on a 0-4 scale, this radiographic classification evaluates the severity of osteoarthritis. Progression indicates worsening joint degeneration.
Time frame: Preoperative and minimum 24-month postoperative radiographs
Medial Joint Space Width (JSW)
Measured in millimeters (mm) on standing AP radiographs as the minimum vertical distance between the medial femoral condyle and tibial plateau. Reflects cartilage loss or joint space narrowing.
Time frame: Preoperative and minimum 24-month postoperative radiographs
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