A previous study by De Smet et al. The diagnosis of tears of the anterior horn of the meniscus by magnetic resonance imaging (MRI) is sometimes different from that obtained by arthroscopic examination. There are 3 main types, according to the Watanabe classification:18. This is a critical differentiation because the latter represents meniscal tears that can be Thirty-one of these patients underwent subsequent arthroscopic evaluation to allow clinical correlation. Meniscal root tears are a form of radial tear that involves the central attachment of the meniscus (12a). Tears Direct intraarticular injection of 20-50 mL of dilute iodinated contrast is performed with rapid image acquisition using multidetector CT with high spatial resolution and multiplanar reformatted images. Longitudinal lateral meniscus tear status post repair (arrow). [emailprotected]. History of a longitudinal medial meniscus tear managed by repair and concurrent ACL reconstruction. ADVERTISEMENT: Supporters see fewer/no ads. When interpreting MR images of the knee, it is important to assess for any change from the expected shape of the menisci. Am J Sports Med 2017; 45:884891, Zaffagnini S, Grassi A, Marcheggiani Muccioli GM, et al. As visualized on sagittal MR images, the anterior horn of the medial meniscus is shorter than the posterior horn, whereas the anterior and posterior horns of the lateral meniscus are of equal length. An intact meniscal repair was confirmed at second look arthroscopy. Davidson D, Letts M, Glasgow R. Discoid meniscus in children: Treatment and outcome. 800-688-2421. Tears in the red zone have the potential to heal and are more amenable to repair. (as previously described), meniscal cyst,26 discoid lateral meniscus in the same knee (Figure 9),25 and pathologic medial patella plica.27. partly divides a joint cavity, unlike articular discs, which completely A recurrent tear was proved at second look arthroscopy. Note the symmetrical shape of the lateral meniscus (left) with similar size of the anterior and posterior horns. AJR American journal of roentgenology. The reported prevalence is 0.06% to 0.3%.25 Am J Sports Med 2010; 38:15421548, LaPrade RF, Matheny LM, Moulton SG, James EW, Dean CS. No gadolinium extension into the meniscus on fat-suppressed sagittal T1-weighted (9B) post arthrogram view. Additionally, the postoperative complication of new extensive synovitis is apparent on the axial view (18D). Radial Meniscal Tear: Pearls May be degenerative or traumatic, vertical, millimeters in size, on the inner edge of the lateral meniscus more commonly than the medial meniscus That reported case was also associated with They found that 76 (8%) of these indicated a tear of the anterior horn of either the medial or lateral meniscus. It has been calculated that the lateral meniscus absorbs about 70% of the forces across the lateral compartment of the knee. 15 year old patient with prior extensive lateral partial meniscectomy was treated with lateral chondroplasty and lateral meniscal allograft transplant with continued pain and clicking 6 weeks post-operative. problem in practice. The posterior horn is always larger than the anterior horn. Radiographs may Atypically thick and high location Am J Sports Med 2017; 45:4249, ElAttar M, Dhollander A, Verdonk R, Almqvist KF, Verdonk P. Twenty six years of meniscal allograft transplantation: is it still experimental? 2059-2066, Kinsella S.D., and Carey J.L. The anterior root of the lateral meniscus attaches to the tibia, just lateral to the midline and posterior to fibers of the anterior cruciate ligament (ACL). The most common location is the anterior horn-body junction of the lateral meniscus and less commonly in the mid posterior horn or root of the medial meniscus. Lateral meniscus tears of the posterior root are a common concomitant injury to anterior cruciate ligament (ACL) tears [6, 16, 20]. Most horizontal tears extend to the inferior articular surface. The MRI revealed a longitudinal tear in the posterior horn of the lateral meniscus. medial meniscus are extremely uncommon and should not be a diagnostic MRI features are consistent with torn lateral meniscus with flipped anterior horn superomedial and posterior, resting superior to the posterior horn. A 64-year-old female with no specific injury presented with knee pain, swelling, and locking that she first noticed after working out at the gym. RESULTS. Check for errors and try again. Normal shape and signal of the horns of the medial meniscus, with no evidence of tears or degenerations seen. Am J Sports Med 2016; 44:625632, De Smet AA, Horak DM, Davis KW, Choi JJ. Meniscal root tears are defined as radial tears located within 1 cm from the meniscal attachment or a bony rootavulsion. In the previously reported cases, as well as in this case, the This is because most tears occur in the posterior horns [, Whether a torn meniscus is reparable depends on the type or pattern of tear, its location, and the quality of the meniscal tissue. This emphasizes the importance of baseline MRI comparison for evaluation of the postoperative meniscus.3. An abnormal shape may indicate a meniscal tear or a partial meniscectomy. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. The meniscus is diffusely vascularized in early life but in adults, only 10-30% of the peripheral meniscus is vascularized, often referred to as the red zone. Lee, J.W. A classification system developed by the International Society of Arthroscopy, Knee Surgery, and Orthopedic Sports Medicine [, Longitudinal-vertical tear. mesenchymal mass that differentiates into the tibia, femur, and The lateral . The fat-suppressed sagittal T1-weighted post arthrogram view (7C) demonstrates gadolinium extending into the meniscal substance. This case features the following signs of meniscal tear: Case courtesy, Prof. Dr. Khaled Matrawy, Professor of radiology, Alexandria university, Egypt. Magnetic resonance imaging of the postoperative meniscus: resection, repair, and replacement. Discoid medial menisci are much less common than discoid lateral menisci,24 and they may be bilateral. Sagittal T2-weighted (18B) and fat-suppressed sagittal proton density-weighted sagittal (18C) images demonstrate fluid-like signal in the posterior horn suggestive of a recurrent tear. A tear of the anterior horn of the lateral meniscus is damage to the front part of one of the two structures that act as shock absorbers between the thigh bone and the lower leg, explains The Steadman Clinic. This article focuses on ligament, and the posterior horn may translate or rotate due to Arthroscopy revealed a horizontal tear of PHMM, and a partial medial meniscectomy was performed. These findings are also frequently associated with genu Sagittal proton density-weighted image (5B) through the medial meniscus at age 17 reveals an incomplete tibial surface longitudinal tear (arrow) in a new location and orientation. Grade 3 is a true meniscus tear and an arthroscope is close to 100 percent accurate in diagnosing this tear. discoid lateral meniscus, including a propensity for tears to occur and The symptoms that this rare condition is also clinically asymptomatic. Indications for a partial meniscectomy include meniscal tears not amenable to repair which includes non-peripheral tears with a horizontal, oblique or complex tear pattern and nontraumatic tears in older patients. Sagittal proton density-weighted image (7A) through the medial meniscus demonstrates increased signal extending to the tibial surface (arrow). A meniscal allograft transplant frequently leads to significant improvements in pain and activity level and hastens the return to sport for most amateur and professional athletes.13 A common method of meniscal allograft transplant includes a cadaveric meniscus (fresh or frozen) attached by its anterior and posterior roots to a bone bridge with a trapezoidal shape harvested from a donor tibia. In cases like this, MR arthrography is quite helpful. The incidence of lateral meniscus posterior root tears was approximately 4 times higher than of medial meniscus posterior root tears in both primary (12.2% vs 3.2%) and revision (20.5% vs 5.6%) ACLRs. Meniscal surgery is common and requires accurate post-operative imaging interpretation to guide the treatment approach. Am J Sports Med. Root tears are associated with a high risk for osteoarthritis. typically into the anterior cruciate ligament. These are like large radial tears and can destabilize a large portion of the meniscus. is affected. Schwenke M, Singh M, Chow B Anterior Cruciate Ligament and Meniscal Tears: A Multi-modality Review. Their conclusion that one should not perform surgery unless clinical correlation exists with effusions, mechanical catching or locking, or the failure to respond to nonoperative measures I believe is a good recommendation that we can all follow. Clin Orthop Relat Res 2013; 471: pp. It is believed that discoid of these meniscal variants is the discoid lateral meniscus, and the 9 The lateral meniscus is more loosely attached than the medial and can translate approximately 11mm with normal knee motion. Anterior horn lateral meniscus tear A female asked: Mri: "macerated anterior horn lateral meniscus with inferiorly surfacing tear. diminutive (1 mm) with no increased signal to suggest root attachment | Semantic Scholar Significant increase in signal intensity at the anterior horn of the lateral meniscus near its central attachment site on sagittal magnetic resonance (MR) images of the knee is a normal finding. found that the absence of a line of increased signal through the meniscus extending to the articular surface on proton density and T2-weighted images was a reliable MRI finding for an untorn post-operative meniscus with 100% sensitivity. Knee Surg Sports Traumatol Arthrosc. The medial meniscus is more tightly anchored than the lateral meniscus, allowing for approximately 5mm of anterior-posterior translation. Report Congenital absence of the meniscus is extremely rare and has been documented in TAR syndrome and in isolated case reports.2,3 Longitudinal medial meniscus tear managed by repair (arrow). Direct and indirect MR arthrography have been shown to be superior to conventional MRI for detection of recurrent meniscal tears in greater than 25% partial meniscectomies and meniscal repairs; however, conventional MRI is commonly used for initial evaluation of the postoperative meniscus with MR arthrography reserved for equivocal cases. Mechanical rasping or trephination of the torn meniscus ends and parameniscal synovium is used to promote bleeding and vascular healing. The medial meniscus is more firmly attached to the tibia and capsule than the lateral meniscus, presumably leading to the increased incidence of tears of the medial meniscus [ 8, 11, 12 ]. The common insertion of the anterior cruciate ligament (ACL) and the AHLM root may provide a pathway for disease. These tears are usually degenerative in nature and usually not associated with a discrete injury [. Evaluate the TCO of your PACS download >, 750 Old Hickory Blvd, Suite 1-260Brentwood, TN 37027, Focus on Musculoskeletal and Neurological MRI, Meniscal tears: the effect of meniscectomy and of repair on intraarticular contact areas and stress in the human knee. Clark CR, Ogden JA. The lateral meniscus attaches to the popliteus tendon and capsule via the popliteomeniscal fascicles at the posterior horn and to the medial femoral condyle by the meniscofemoral ligaments. are reported cases of complete absence of the medial meniscus as The most important clinical concern at the time of MRI imaging is often high-grade articular cartilage loss. Anatomic variability and increased signal change in this area are commonly mistaken for tears. The remaining 42 cases were located in the red zone (19 cases) or the red-white zone. It is located in the lateral portion of the knee interior of the knee joint. We will review the common meniscal variants, which Dr. Diduch, Associate Professor, Department of Orthopaedic Surgery, University of Virginia School of Medicine, Charlottesville, VA, is Editor of Sports Medicine Reports. 17. Lateral meniscus extrusion was present in six (23%) of 26 LMRTs and five (2.2%) of 231 patients with normal meniscus roots ( P < .001). Controlling Blood Pressure During Pregnancy Could Lower Dementia Risk, Researchers Address HIV Treatment Gap Among Underserved Population, HHS Announces Reorganization of Office for Civil Rights, FDA Adopts Flu-Like Plan for an Annual COVID Vaccine. Kim EY, Choi SH, Ahn JH, Kwon JW. The torn edges are aligned, and stable fixation applied with sutures or bioabsorbable implants at approximately 5 mm intervals. The most widely used diagnostic modalities to assess the ligament injuries are arthroscopy and Magnetic Resonance Imaging (MRI). In contrast to the medial meniscus, the posterior horn of the lateral meniscus is additionally secured by the meniscofemoral ligaments (MFL). discoid meniscus, although discoid medial menisci can occur much less There is a medial and a lateral meniscus. Meniscal tears were found on MRI or arthroscopy in all 28 patients with a lateral cyst overlying the body or posterior horn of the lateral meniscus, whereas a tear was found on MRI or arthroscopy in only 14 (64%) of 22 patients with cysts adjacent to or extending to the lateral meniscus anterior horn (p = 0.006). Evaluation of postoperative menisci with MR arthrography and routine conventional MRI. The patient underwent a successful partial medial meniscectomy and was encouraged to seek low-impact exercise. The meniscus is two crescent-shaped, thick pieces of cartilage that sit in the knee between the tibia and the femur. no financial relationships to ineligible companies to disclose. The LaPrade classification systemof meniscal root tears has become commonly used in arthroscopy, and there is evidence that this system can be to some extent translated to MRI assessment of these tears ref. On examination, the patient had medial joint line tenderness with positive McMurray test. Repair devices including arrows, darts and sutures are used to approximate the torn edges of the meniscus. meniscus is partial meniscal excision, leaving a 6- to 7-mm peripheral Surgery is useful if they are unstable and flipping in and out of the joint causing pain. of the transverse ligament is comparable to the general population.5. Following meniscal allograft transplantation (Figure 17), complications occur in up to 21% of procedures, including allograft failure and progressive cartilage loss.19 Repeat operations occur in up to 35% of patients, 12% requiring conversion to total knee arthroplasty. 1427-143. does not normally occur.13. The example above demonstrates the importance of baseline MRI comparison when evaluating the postoperative meniscus. If a horizontal tear involves a long segment of the meniscus, the central fragment may displace centrally from the peripheral portion of the meniscus [, Bucket handle tears (BHT) often cause pain and mechanical symptoms, such as locking, catching, and giving way [. If a meniscus tear shows up on a MRI, it is considered a Grade 3. collapse and widening of the medial joint space (Figure 7). ; Lee, S.H. described in thrombocytopenia absent radius syndrome (TAR syndrome).2,3 Bilateral hypoplasia of the medial meniscus has also been reported.4. The medial meniscus covers 60% of the medial compartment. Absence of the meniscus results in a 200 to 300% increase in contact stresses on the articular surfaces.8The meniscus has a heterogeneous cellular composition with regional and zonal variation, with high proteoglycan content at the thin free edge where compressive forces predominate and low proteoglycan content at the thicker peripheral region where circumferential tensile loads predominate. There is no universally accepted system for classifying meniscal tear patterns. 5 In the first instance, tears of the lateral aspect of the anterior horn of the medial meniscus are extremely uncommon and should not be a diagnostic MRI: When you tear your meniscus, a magnetic resonance imaging (MRI) scan will show the injury as white lines on black. Meniscal root tear. of the AIMM into the ACL is classified as Type 1 (inferior third), Type 2 2014; 43:10571064, McCauley TR. In Surgical Outcomes Lysholm Score They may not even be apparent with an arthroscopic examination. Diagnostic performance is decreased following partial meniscectomy since the standard criteria used to diagnose a meniscus tear cannot be applied to the post-operative meniscus.3,4,5,6 Partial meniscectomy may distort the normal morphology of the meniscus and increased meniscal signal intensity may extend to the articular surface when a portion of the meniscus has been resected, simulating a tear. At surgery, the torn part of the meniscus was in the intercondylar notch and chewed up and not amenable to repair. Arthrofibrosis and synovitis are also relatively common. Otherwise, the increased vascularity in children has sometimes led to false-positive reading of a meniscus tear. Best assessed on T2 weighted sequences. Both ligaments attach distally to the posterior horn of the lateral meniscus and contribute to posterior drawer stability . 4. Damaged meniscal tissue is removed with arthroscopic instruments including scissors, baskets and mechanical shavers until a solid tissue rim is reached with the meniscal remnant contoured, preserving of as much meniscal tissue as possible. Anterior tibial marrow edema and organized trabecular fracture measuring 16 mm AP, 18 mm transverse. Horizontal (degenerative) tears run relatively parallel the tibial plateau. Findings indicate an intact meniscus following partial meniscectomy with normal intrameniscal signal. You have reached your article limit for the month. At the time the article was last revised Yahya Baba had Among these 26 studies of an LMRT . Tachibana Y, Yamazaki Y, Ninomiya S. Discoid medial meniscus. MR imaging and MR arthrography for diagnosis of recurrent tears in the postoperative meniscus. CT arthrography is recommended for patients with MRI contraindications or when extensive susceptibility artifact from hardware obscures the meniscus. Laundre BJ, Collins MS, Bond JR, Dahm DL, Stuart MJ, Mandrekar JN: MRI accuracy for tears of the posterior horn of the lateral meniscus in patients with acute anterior cruciate ligament injury and the clinical relevance of missed tears. Because most meniscal tears are not isolated to the red zone, it is understandable that most meniscal surgeries are partial meniscectomies which aim to restore meniscus stability while preserving as much native meniscal tissue as possible, to decrease the risk of osteoarthritis. This case is almost identical to the previous case with a different clinical history. Results: Arthroscopic examination of the anterior horn of the lateral meniscus in all 22 patients was normal. Brody J, Lin H, Hulstyn M, Tung G. Lateral Meniscus Root Tear and Meniscus Extrusion with Anterior Cruciate Ligament Tear. Meniscus repair is superior to partial meniscectomy in preventing osteoarthritis and facilitating return to athletic activity.11 However, the period of postoperative immobilization and activity restriction associated with meniscus repair is longer than that associated with partial meniscectomy and requires a compliant, motivated patient to be successful. Congenital discoid cartilage. the menisci of the knees. Comparison of Postoperative Antibiotic Regimens for Complex Appendicitis: Is Two Days as Good as Five Days? Type 1 is most common, and type variants of the meniscus are relatively uncommon and are frequently AJR Am J Roentgenol. Indications for meniscal repair typically include posttraumatic peripheral (red zone) longitudinal tears located near the joint capsule, ideally in younger patients (less than 40). The lateral meniscus is one of two fibrocartilaginous menisci of the knee. 1991;7(3):297-300. 2006; 187:W565568. 1). Tear between 1-4 cm vertical tear red-red meniscal root <40 yo Maybe concominant ACL surgery . This arises from the posterior horn of the lateral meniscus and attaches to the lateral aspect of the medial femoral condyle. Bilateral hypoplasia of the medial meniscus has also been The patient failed conservative management of aspiration and cortisone injection. Type The MRI revealed a vertical flap (oblique) tear of the medial meniscus. For DSR inquiries or complaints, please reach out to Wes Vaux, Data Privacy Officer, With age, increased connective tissue stiffness of the meniscus develops secondary to elastin degradation and collagen rigidification.2. Shepard et al have done a nice job of telling us just how frequently this mistake can be made by fellowship trained musculoskeletal radiologists. Cho JM, Suh JS, Na JB, et al. The main functions However, recognizing these variants is important, as they can congenital absence of the cruciate ligaments. Extrusion is commonly seen following root repair. 2006;239(3):805-10. 7 Therefore, it is important for the radiologist to be familiar with the appearance of a recurrent tear versus an untorn postoperative meniscus. The location of meniscal tears or signal alterations (anterior/posterior horn or body of the medial/lateral meniscus) and the grade (normal/intra-substance signal abnormality = 0 and tear = 1) were determined on 2D . for the ratio of the sum of the width of the anterior and posterior Imaging characteristics of the joint, and they also protect the hyaline cartilage. Is sport activity possible after arthroscopic meniscal allograft transplantation? Presentation - Middle-older aged individuals, non-traumatic, progressive onset of pain. Become a Gold Supporter and see no third-party ads. Unable to process the form. The most frequent symptom is pain that usually begins with a minor the medial meniscus. anterior horn of the medial meniscus into the anterior cruciate ligament with mechanical features of clicking and locking. . Discoid lateral meniscus (DLM) is a common anatomic variant in the knee typically presented in young populations, with a greater incidence in the Asian population than in other populations. Klingele KE, Kocher MS, Hresko MT, et al. this may extend to to the mid body." is this a bucket tear? Midterm results in active patients. Mucinous degeneration of meniscus can also produce abnormal signal within a meniscus which does not contact an articular surface and should not be mistaken for a tear. Clin Orthop Relat Res 2012; 470: pp. (PubMed: 17114506), BakerJC, FriedmanMV, RubinDA (2018) Imaging the postoperative knee meniscus: an evidence-based review. seen on standard 4- to 5-mm slices.21 The Wrisberg ligament may also be thick and high in patients with a complete discoid lateral meniscus.22 Other criteria used to diagnose lateral discoid meniscus include the following: In the In this case, we can determine that there is a new tear in a different location. The posterior cruciate ligament is intact. What are the findings? Posterior root repair (Figure 16) is being performed with increasing frequency and has been shown to have better outcomes and decreased risk of osteoarthritis compared to posterior root tears treated non-operatively. of the anterior horn of the medial meniscus, an inferior patella plica, Both the healed peripheral tear and the new central tear were proved at second look arthroscopy. Sagittal proton density-weighted image (10A) demonstrates increased signal extending to the articular surface consistent with granulation tissue. Discoid meniscus in children: Magnetic resonance imaging characteristics. Suprapatellar plica noticed, with no related cartilaginous erosions. An athletic 52-year-old male, who was an avid runner all his adult life, presented with medial pain and a popping sensation in knee. Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window), Click to share on Google+ (Opens in new window), Posterior Instability and Labral Pathology, Imaging Evaluation of the Painful or Failed Shoulder Arthroplasty, Other Entities: PLRI, HO, Triceps, and Plica, MRI-Arthroscopy Correlations in the Overhead Athlete, Acetabular Fossa, Femoral Fovea, and the Ligamentum Teres. Anterior horn of the lateral meniscus: another potential pitfall in MR imaging of the knee. However, few studies have directly compared the medial and lateral root tears. Considered a feature of knee osteoarthritis. Knee Surg Sports Traumatol Arthrosc 2011; 19:147157, Gwathmey F.W., Golish S.R., Diduch D.R., et al: Complications in brief: meniscus repair. trauma; however, other symptoms include clicking, snapping, and locking Resnick D, Goergen TG, Kaye JJ, et al. trials, alternative billing arrangements or group and site discounts please call The lateral meniscus is more circular, and its anterior and posterior horns are nearly equivalent in size in cross section. Singh K, Helms CA, Jacobs MT, Higgins LD. Problems encountered in a discoid medial meniscus are the same as a Development of the menisci of the human knee History of medial meniscus posterior horn and body partial meniscectomy. They maintain a relatively constant distance from the periphery of the meniscus [. proximal medial tibia was convex and the distal medial femoral condyle On MR arthrography, (12B), gadolinium extends through the repair site indicating a tear. Diagnosis of recurrent meniscal tears: prospective evaluation of conventional MR imaging, indirect MR arthrography, and direct MR arthrography. The superior, middle and inferior geniculate arteries are the main vascular supply to the menisci. Sagittal proton density-weighted image (6A) through the medial meniscus following partial meniscectomy and debridement of the inferior articular surface shows increased PD signal contacting the inferior articular surface (arrow) but no T2 fluid signal at the surgical site (6B) and no gadolinium signal in the meniscus (6C). Kocher MS, Klingele K, Rassman SO. snapping knee due to hypermobility. Discoid medial meniscus. The intrameniscal ligament where it diverges from the back of the anterior horn of the lateral meniscus is also a common area misinterpreted as a tear. Reference article, Radiopaedia.org (Accessed on 04 Mar 2023) https://doi.org/10.53347/rID-40036, {"containerId":"expandableQuestionsContainer","displayRelatedArticles":true,"displayNextQuestion":true,"displaySkipQuestion":true,"articleId":40036,"questionManager":null,"mcqUrl":"https://radiopaedia.org/articles/meniscal-root-tear/questions/1112?lang=us"}. Papalia R, Vasta S, Franceschi F, D'Adamio S, Maffulli N, Denaro V. Meniscal Root Tears: From Basic Science to Ultimate Surgery. small meniscus is also seen in the wrist joint. Magnetic resonance imaging (MRI) revealed an elongated free edge of the diffusely enlarged lateral meniscus extending toward the intercondylar region on coronal T1-weighted images (Figure 1A). The meniscal repair is intact. menisci (Figure 8). MRI of the knee is commonly indicated for evaluation of unresolved or recurrent knee pain following meniscal surgery. Because this is a relatively new procedure, few studies have been dedicated to MRI evaluation of postoperative root repair. Generally, Disadvantages include risks associated with joint injection, radiation exposure and lower contrast resolution compared to MRI, particularly in the extraarticular soft tissues. The intrameniscal ligament where it diverges from the back of the anterior horn of the lateral meniscus is also a common area misinterpreted as a tear. Illustration of the medial and lateral menisci. MRIs of BHT may have several characteristic appearances including (1) fragment in the notch sign; (2) double anterior horn sign, in which there is an additional meniscal fragment in the anterior joint on top of the native anterior horn; (3) the absent bow tie sign; (4) the double PCL sign, in which the centrally displaced fragment lies just anterior and parallel to the PCL giving the appearance of two PCLs; and (5) the coronal truncation sign, in which the free edge of the meniscal body appears clipped off on coronal images (Fig. A detached posterior root is functionally equivalent to a total meniscectomy with loss of its ability to withstand hoop stress. A preliminary report, Principles and decision making in meniscal surgery, The Anterior Meniscofemoral Ligament of the Medial Meniscus, Accurate patient history including site and duration of symptoms, Garrett WE Jr, Swiontkowski MF, Weinstein JN, et al. Proper preoperative sizing of the allograft is critical for surgical success and usually performed with radiographs. 10 A Br Med Bull. This scan showed a radial MMT. Discoid lateral meniscus in children. Thus, the loss of the lateral meniscus can often lead to rather rapid onset of osteoarthritis. Menisci are present in the knees and the Lee S, Jee W, Kim J. Sagittal proton density-weighted image (5A) through the medial meniscus at age 12 shows the initial horizontal tear in the posterior horn (arrow) subsequently treated with partial meniscectomy. pretzels dipped in sour cream. Youderian A, Chmell S, Stull MA.
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