Medial Meniscal Extrusion in Patients With Medial Meniscus Root Tears: A Systematic Review and Meta-analysis

Francis Jia Yi Fong; Bryan Wei Loong Ong; Yee Han Dave Lee

doi:10.1177/23259671231151698

Medial Meniscal Extrusion in Patients With Medial Meniscus Root Tears: A Systematic Review and Meta-analysis

Orthop J Sports Med. 2023 Mar 6;11(3):23259671231151698. doi: 10.1177/23259671231151698. eCollection 2023 Mar.

Authors

Francis Jia Yi Fong¹, Bryan Wei Loong Ong², Yee Han Dave Lee²

Affiliations

¹ Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
² Department of Orthopaedic Surgery, National University of Singapore, Singapore.

Abstract

Background: Medial meniscal extrusion (MME) has received significant interest because of its correlation with medial meniscus root tears (MMRTs), its potential as a diagnostic tool, and its significance in the progression of knee osteoarthritis (OA).

Purpose: To (1) evaluate if MMRTs significantly increase MME compared with nonroot tears (NRTs) and no tears and (2) determine the clinical outcomes of increased MME.

Study design: Systematic review; Level of evidence, 4.

Methods: Electronic database searches of PubMed, Embase, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials were conducted on June 6, 2022, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 checklist criteria. The searches were conducted using the keywords "meniscus tear" and "extrusion." No restrictions were placed on the date of publication. Quality and sensitivity assessments were conducted on included studies. Major MME was defined as an extrusion ≥3 mm.

Results: Twenty-two studies involving 7882 knees were included. Compared with patients with NRTs, those with MMRTs had a 1.12-mm greater mean absolute meniscal extrusion (AME) and were 3.45 times more likely to have major MME (P < .001 for both). Compared with patients with no tears, those with MMRTs had a 2.13-mm greater AME (P < .001). Within patients with MMRT, those with widely displaced MMRT had a 1.01-mm greater AME compared with nondisplaced MMRT (P < .001). Patients with OA had a 0.73-mm greater AME and were 3.86 times more likely to have major MME compared with patients without OA (P < .001 for both). Within patients who were not stratified according to MMRT, NRT, or no tears, those who eventually developed OA had a 0.79-mm greater AME than those who did not have OA (P = .02).

Conclusion: Patients with MMRTs had higher MME values compared with those with other types of meniscal tears and those without any meniscal tears. Patients with knee OA were more likely to have higher MME compared with those without OA.

Keywords: knee; meniscal extrusion; meniscus root tear; osteoarthritis.

Publication types

Review