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Meniscal Tear Classification

 Flap Meniscal Tear  picture Flap Meniscal 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 Meniscal Tear picture Radial Meniscal 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.
Longitudinal Meniscal Tear Longitudinal Meniscal Tear
  • 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
Bucket Handle Meniscal Tear Bucket Handle Meniscal Tear
  • Generally repairable especially if associated with an ACL tear.
  • Often related to trauma.
  • Treatment = Meniscal 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

  Horizontal cleavage Meniscal Tear
  • More likely preesisting / degenerative
Complex / Degenerative Meniscal Tear Complex / Degenerative Meniscal Tear
  • 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.
 discoid lateral meniscus Discoid Meniscus
  Meniscal Root Avulsion
  • synonyms: posterior horn medial meniscal avulsion, meniscal root tear
  • Treatment: arthroscopic repair via bone tunnels. (Marzo JM, JAAOS 2009;17:276).

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