Related Experiment Video
Updated: Aug 2, 2026
Destabilization of the Medial Meniscus and Cartilage Scratch Murine Model of Accelerated Osteoarthritis
Published on: July 6, 2022
Reliable labels, uncertain meaning: Classifications for medial meniscus posterior root tears lack consensus and
Michelangelo Palco1, Gabriele Giuca2, Filippo Familiari3
1Department of Orthopaedic and Trauma Surgery, Casa di Cura Caminiti, Villa San Giovanni, Italy.
Purpose:
Multiple, nonharmonised classification systems exist for posterior medial meniscus root tears (PMMRT), yet their diagnostic accuracy and observer reliability remain unclear. This PRISMA-2020 systematic review aimed to catalogue available PMMRT classifications and to summarise accuracy and reliability metrics.
Methods:
Searches (PubMed, Scopus, Cochrane CENTRAL, Ovid MEDLINE/Embase; English; humans; no date/design limits; 9 September 2025) identified 2849 records; 1920 unique records were screened and 228 full texts assessed; six studies were eligible. Risk of bias followed QUADAS-2 for diagnostic accuracy and GRRAS/COSMIN for reliability. Study-specific interobserver κ and measurement ICC (with 95% confidence interval [CIs]) were extracted. Arthroscopy-validated diagnostic accuracy was available from one study; no pooling was performed.
Results:
One arthroscopy-validated MRI study reported high accuracy for radial PMMRT (sensitivity 0.90; specificity 0.94). Interobserver agreement for MRI-based classification/diagnosis was high in two studies (κ = 0.86-0.93). MRI measurement repeatability for extrusion/tear-gap was good-to-excellent (ICC: 0.80-0.92). No study prospectively linked subtype to treatment or outcomes.
Conclusion:
MRI-based PMMRT classifications show high interobserver agreement, but arthroscopy-validated accuracy evidence remains limited (single study); no system can be endorsed as most robust. A consensus, outcome-anchored anatomical taxonomy and multicenter, arthroscopy-validated studies linked to clinical outcomes are required before standardisation.
Level Of Evidence:
Level III.
Clinical Trial Registration:
PROSPERO registration number: CRD420251103590.
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