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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| MMPRT Patients | Patients with medial meniscus posterior root tears undergoing arthroscopic repair. | ||
| Control Patients | Patients without meniscus tears, matched by age, BMI, and mechanical axis. |
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| Measure | Description | Time Frame |
|---|---|---|
| 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. | 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 | 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. | 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. | 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. | 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. | Preoperative MRI assessment |
| Measure | Description | Time Frame |
|---|---|---|
| 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. | Preoperative and minimum 24-month postoperative follow-up |
| Lysholm Knee Score |
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Inclusion Criteria:
Patients aged 18 years or older
Arthroscopically confirmed medial meniscus posterior root tear (MMPRT) diagnosis
Availability of preoperative knee MRI and standing long-leg radiographs
Minimum 24-month clinical and radiographic follow-up
Exclusion Criteria:
Lateral meniscus tear
Kellgren-Lawrence grade 3 or higher knee osteoarthritis
Advanced ligament injuries
History of previous knee surgery, osteotomy, or arthroplasty
Poor imaging quality
Mechanical axis deformities (varus or valgus alignment)
Follow-up period less than 24 months
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The study population includes adult patients diagnosed with medial meniscus posterior root tear (MMPRT) who underwent arthroscopic repair at Karadeniz Technical University Farabi Hospital between 2020 and 2024, as well as control patients without meniscus tears who had knee MRI and standing radiographs available in the same period. Controls were matched to the MMPRT group based on age, BMI, and mechanical axis distribution to minimize confounding.
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| Name | Affiliation | Role |
|---|---|---|
| Fevzi Gurkan Aslan, M.D. | Karadeniz Technical University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Karadeniz Technical University, Orthopedic and Traumatology Department | Trabzon | Turkey (Türkiye) |
No individual participant data (IPD) will be shared for this study. Only aggregate results and statistical analyses will be published to protect patient confidentiality.
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| ID | Term |
|---|---|
| D000070600 | Tibial Meniscus Injuries |
| ID | Term |
|---|---|
| D007869 | Leg Injuries |
| D014947 | Wounds and Injuries |
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| 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. |
| 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. | 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. | 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. | 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. | 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. | 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. | 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. | 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. | Preoperative MRI |
Scored from 0 to 100, this questionnaire evaluates limping, support, locking, pain, swelling, stair climbing, and squatting. Higher scores indicate better knee function. |
| 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. | 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. | 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. | Preoperative and minimum 24-month postoperative radiographs |