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Journal of Bone and Joint Surgery - British Volume, Vol 91-B, Issue 2, 190-195.
doi: 10.1302/0301-620X.91B2.21097  
Copyright © 2009 by British Editorial Society of Bone and Joint Surgery
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Meniscal root injury and spontaneous osteonecrosis of the knee

AN OBSERVATION

D. D. Robertson, MD, PhD, Visiting Professor1; D. R. Armfield, MD, Radiologist2; J. D. Towers, MD, Associate Professor3; J. J. Irrgang, PhD, Professor4; W. J. Maloney, MD, Professor and Chair5; and C. D. Harner, MD, Professor4

1 Carnegie Mellon University, 403 Landon Gate, Pittsburgh, Pennsylvania 15238, USA.
2 Jefferson Regional Medical Center, 575 Coal Valley Road, Pittsburgh, Pennsylvania 15236, USA.
3 UPMC St. Margaret’s Hospital, 815 Freeport Road, Pittsburgh, Pennsylvania 15215, USA.
4 Department of Orthopaedic Surgery University of Pittsburgh, 3471 Forbes Avenue, Pittsburgh, Pennsylvania 15213, USA.
5 Department of Orthopaedic Surgery Stanford University, 300 Pasteur Drive, Palo Alto, California 94305, USA.

Correspondence should be sent to Professor D. D. Robertson; e-mail: ddrobertson2{at}hotmail.com

We describe injuries to the posterior root of the medial meniscus in patients with spontaneous osteonecrosis of the medial compartment of the knee. We identified 30 consecutive patients with spontaneous osteonecrosis of the medial femoral condyle. The radiographs and MR imaging were reviewed. We found tears of the posterior root of the medial meniscus in 24 patients (80%). Of these, 15 were complete and nine were partial. Complete tears were associated with > 3 mm of meniscal extrusion. Neither the presence of a root tear nor the volume of the osteonecrotic lesion were associated with age, body mass index (BMI), gender, side affected, or knee alignment. The grade of osteoarthritis was associated with BMI.

Although tears of the posterior root of the medial meniscus were frequently present in patients with spontaneous osteonecrosis of the knee, this does not prove cause and effect. Further study is warranted.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General