1. To evaluate and classify different morphological patterns of posterior horn medial meniscus root tears (PHMMRTs) and assess their correlation with clinical presentation, MRI findings, and arthroscopic features.
2. To determine the association between tear patterns and degree of meniscal extrusion.
3. To evaluate the relationship between tear patterns and articular cartilage degeneration.
4. To identify predictors of specific tear patterns based on clinical and radiological findings

The medial meniscus posterior horn root plays a pivotal role in maintaining normal knee biomechanics by converting axial loads into circumferential hoop stresses. Injury to this structure leads to loss of meniscal function, increased tibiofemoral contact pressure, and accelerated degeneration of articular cartilage, resembling the biomechanical effects of total meniscectomy.

Posterior horn medial meniscus root tears (PHMMRTs) present with various morphological patterns, including radial tears, oblique tears, complex tears, and complete root avulsions. Each tear pattern has distinct clinical, radiological, and arthroscopic characteristics, which may influence management strategies and prognosis. Despite increasing recognition of these injuries, data correlating tear patterns with clinical presentation and imaging findings remain limited.

Despite increasing recognition of PHMMRTs, limited studies have comprehensively correlated different tear patterns with clinical, radiological, and arthroscopic findings in a single prospective cohort. This study aims to fill this gap and provide clinically applicable correlations that may guide decision-making and prognosis assessment

Inclusion Criteria:

• Patients aged ≥18 years (no upper age limit, as PHMMRTs are prevalent in elderly population)
• Clinical suspicion of medial meniscal injury
• MRI-confirmed posterior horn medial meniscus root tear
• Patients undergoing diagnostic or therapeutic knee arthroscopy

Exclusion Criteria:

• Previous surgical intervention to the affected knee
• Lateral meniscus root tears
• Advanced knee osteoarthritis (Kellgren-Lawrence grade IV)
• Inflammatory or rheumatoid arthritis
• Acute ligamentous injuries requiring immediate surgical intervention

study population will include patients presenting to orthopedic surgery department at Assiut university