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Meniscal Flap Tears on MRI: Patterns of Fragment Migration and Associated Lesions
Ezgi S Bayraktar1, Atilla H Cilengir2, Tugce Ekici3
1Department of Radiology, Aydin State Hospital, Aydin.
Objective:
Displaced fragments in meniscal flap tears may be challenging to detect radiologically but are clinically relevant for treatment planning. This study aimed to characterize fragment migration patterns on MRI and evaluate associated intra-articular pathologies.
Methods:
In this retrospective analysis of 89 knee MRIs performed between January 2018 and May 2022, patients with confirmed meniscal flap tears were assessed for tear location, fragment displacement direction, and associated findings, including cartilage defects, ligament injuries, bone marrow edema, osteophytes, osteochondral lesions, and joint effusion. Statistical associations between tear features and accompanying pathologies were evaluated.
Results:
Inferior coronary recess was the most frequent displacement site, especially in medial tears (68.8%, P =0.007). Medial tears more often had cartilage defects (66.3%, P =0.024) and osteochondral lesions (55.0%, P =0.015). Posterior horn involvement predominated, and ACL tears were strongly associated with intercondylar notch displacement (77.8%, P =0.001).
Conclusion:
Meniscal flap tears are most commonly located in the posterior horn of the medial meniscus and tend to displace into the inferior coronary recess. Their frequent association with cartilage damage, osteochondral lesions, and ACL injuries underscores the importance of careful MRI evaluation to support surgical decision-making.
Insights
Meniscal flap tears, often in the posterior medial meniscus, frequently displace fragments into the inferior coronary recess. Associated findings include cartilage damage and ACL injuries, highlighting the need for detailed MRI review.
Area of Science:
- Orthopedic Surgery
- Radiology
- Sports Medicine
Background:
- Meniscal flap tears present diagnostic challenges on MRI.
- Fragment displacement is clinically significant for treatment planning.
Purpose of the Study:
- Characterize fragment migration patterns in meniscal flap tears using MRI.
- Evaluate associated intra-articular pathologies in these tears.
Main Methods:
- Retrospective analysis of 89 knee MRIs (Jan 2018 - May 2022).
- Assessed tear location, fragment displacement, and associated findings (cartilage defects, ligament injuries, bone edema, osteophytes, osteochondral lesions, effusion).
- Statistical evaluation of associations between tear features and pathologies.
Main Results:
- Inferior coronary recess was the most common displacement site (68.8% of medial tears).
- Medial tears frequently showed cartilage defects (66.3%) and osteochondral lesions (55.0%).
- Posterior horn tears and ACL injuries were strongly associated with intercondylar notch displacement (77.8%).
Conclusions:
- Meniscal flap tears commonly occur in the posterior medial meniscus, displacing into the inferior coronary recess.
- Frequent association with cartilage damage, osteochondral lesions, and ACL injuries.
- Emphasizes the importance of thorough MRI evaluation for surgical decision-making.
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