Meniscal Root Tears

What is the meniscal root?

  • The meniscal root is a small portion of the meniscus that attaches and anchors the anterior and posterior horns of the meniscus to the intercondylar fossa or eminence of the tibia.
  • Its usually the posterior root of the meniscus that is torn and medial more than lateral meniscus.

Where is it? It is the component of the meniscus between its tibial attachment and the point on the tibial margin where cartilage ends.

  • meniscus root posterior horn tear

Image Above: Red arrows demonstrate the medial meniscus root. It commences just lateral to the apex of the medial tibial plateau ( yellow arrow). Green arrow and dashed green line demonstrate where cartilage of medial tibial plateau ceases which is another marker for the beginning of the meniscal root.

 

  • meniscus root posterior horn

Image above: Coronal scans yellow arrow in B and C demonstrates attachment of medial meniscus root to tibia anterior to PCL ( green arrow) tibial. Note in Image B blue arrow demonstrates posterior root attachment of lateral meniscus.

Meniscal Root Normal Sagittal

Sagittal Images above: Yellow arrow demonstrates medial meniscus posterior horn and meniscal root ( yellow arrow). Note how meniscal root extends to the level of the PCL ( green arrow).

Why are these tears important? A tear of the meniscal root results in significant dysfunction of the meniscus because

  • The meniscal root anchors the meniscus and prevents its being extruded.
  • This enables the meniscus to generate hoop stress which transfers load from the femur to the tibia without damage to underlying cartilage.
  • The effect of a meniscal root tear is equivalent to having a total meniscectomy in terms of function and increases risk of damage to cartilage.

What do these tears look like?

  • Tears are best seen on the coronal images and then confirmed on the sagittal scans
  • The root of the posterior horn medial meniscus attached immediately anterior to the PCL. On the sagittal scan you should see the posterior horn on every sagittal image until the PCL
  • There should be no fluid between the PCL and the meniscal root on the coronal scans.

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