Bone cysts at the meniscal attachment are associated with a longer symptom duration among patients with arthroscopically treated medial meniscus posterior root tear.

Abstract

Purpose: To elucidate the features of bone cysts at attachment sites of medial meniscus posterior root tears (MMPRTs).

Methods: Knees treated using arthroscopic surgery for MMPRT between 2015 and 2022 were retrospectively reviewed. Patients without a memory of onset (painful popping), prior knee surgeries, concomitant ligament or meniscus injuries or fractures were excluded. Duration from onset to magnetic resonance imaging (MRI) and type of tear were evaluated during arthroscopy. On radiography, meniscus signs (cleft/ghost/giraffe neck), bone cysts at the attachment site of the MMPRT and posterior shiny-corner lesions (PSCLs; bone marrow lesions on the meniscal-covered portion of the posterior tibial plateau) were evaluated. The sensitivity and specificity of the bone cysts were assessed by comparison with matched patients who underwent arthroscopic surgery for medial meniscus posterior horn tear. In addition, subgroups (cyst-positive/cyst-negative) among patients with MMPRT were created to assess the features of bone cysts.

Results: A total of 275 patients with MMPRT and 275 matched patients with posterior horn tears were evaluated. The sensitivity and specificity of bone cysts for MMPRT in this study were 22.2% and 98.6%, respectively. Among the 275 knees with MMPRT, compared with the cyst-negative group, the cyst-positive group had a longer duration from onset to MRI (12.9 ± 13.1 vs. 8.3 ± 10.9 weeks, respectively, p = 0.025) and reduced occurrence of PSCLs (18.0% vs. 42.0%, respectively, p = 0.031).

Conclusion: The occurrence of bone cysts at the attachment site was helpful for the accurate diagnosis of MMPRT and related to longer duration from onset to MRI and reduced PSCLs.

Level of evidence: Level III, cross-sectional study.