The Posterior Horn Dimensions of the Medial Meniscus and Predisposition to Posterior Horn Tears in Young Individuals: An MRI-Based Study
DOI:
https://doi.org/10.59667//sjoranm.v31i1.16Keywords:
Medial meniscus, posterior horn tear, size of posterior horn, dimensions of posterior horn, MRIAbstract
Objective: To evaluate the association between medial meniscus posterior horn dimensions and posterior horn tears in young individuals using MRI, and to determine an optimal cut-off value of posterior horn size associated with the presence of tears.
Material and Methods: This retrospective study included 554 patients aged 15–40 years, divided into tear and non-tear groups based on MRI findings. Meniscal size was assessed by measuring the anteroposterior (AP) diameter of the medial meniscus posterior horn on sagittal MRI images and the transverse diameter on coronal images. Measurements were compared between groups. Receiver operating characteristic (ROC) analysis was performed using the Youden Index to determine optimal cut-off values. Multivariable logistic regression analysis including posterior horn dimensions, age, sex, and body mass index (BMI) was performed to evaluate independent association with posterior horn tears. Interobserver reliability was assessed using intraclass correlation coefficient (ICC).
Results: The tear group demonstrated a significantly larger AP diameter of the medial meniscus posterior horn (18.77 ± 2.29 mm) compared with the non-tear group (14.36 ± 1.64 mm, p < 0.001). Similarly, the transverse diameter was significantly greater in the tear group (19.48 ± 2.75 mm) than in the non-tear group (14.45 ± 1.63 mm, p < 0.001). A cut-off value of ≥17 mm for AP diameter showed a sensitivity of 85.7%, specificity of 90.7%, and AUC of 0.943, while the same cut-off for transverse diameter demonstrated a sensitivity of 92.3%, specificity of 90.7%, and AUC of 0.955. Multivariable logistic regression confirmed that both AP and transverse diameters were independently associated with posterior horn tears after adjustment for age, sex, and BMI. Interobserver reliability showed excellent agreement for both AP (ICC = 0.91) and transverse (ICC = 0.92) measurements.
Conclusion: A significant association exists between increased size of posterior horn medial meniscus and its tears in young individuals, with tears occurring more frequently in those with a larger posterior horn.
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