Meniscal Tear Classification / Treatment

Flap Tear

• Radial tear with extention circumferentially creating a flap of meniscal tissue.
• note red-red(within 3mm of meniscosynovial juntion) vs red-white(3mm-5mm from meniscosynovial junction) vs white-white(>5mm from meniscosynovial junction)
• Generally unrepairable
• Treatment = partial meniscectomy with preservation of normal meniscus.

Radial Tear

• Generally unrepairable because the circumferential hoop fibers are disrupted and the majority of the tear is avascular.
• Often related to trauma.
• note red-red(within 3mm of meniscosynovial juntion) vs red-white(3mm-5mm from meniscosynovial junction) vs white-white(>5mm from meniscosynovial junction)
• <3mm in depth do not require treatment.
• >3mm in depth = partial meniscectomy with preservation of normal meniscus..

• Ideal tear for repair is a longitudinal tear within the peripheral 3mm with a length of 1-2cm.
• Often related to trauma.
• note red-red(within 3mm of meniscosynovial juntion) vs red-white(3mm-5mm from meniscosynovial junction) vs white-white(>5mm from meniscosynovial junction)
• Stable longitudinal tears <5mm in length and that displace <3mm do not require treatment.
• Treatment = repair.

1. Medial femoral condyle
2. Medial capsule
3. Longitudinal medial meniscal tear
4. Medial mensicus

• Generally repairable especially if associated with an ACL tear.
• Often related to trauma.
• Treatment = repair.

1. Medial Femoral Condyle (MFC)
2. Lateral wall of MFC
3. Body of Medial meniscus flipped into the notch
4. Anterior horn of medial meniscus

Bucket Handle Meniscal Tear MRI

• More likely preesisting / degenerative

• Combination of other tears occuring in multiple planes.
• More common in older patients.
• Often in posterior horn.
• Generally unrepairable
• Treatment = partial meniscectomy with preservation of normal meniscus.