The Wave Sign Correlates with the Posterior Horn Medial Meniscus (PHMM) Tear in the Anterior Cruciate Ligament (ACL) Deficient Knee
Introduction: A posterior horn medial meniscus (PHMM) tear subjects the knee to pathological stresses, especially in the setting of a deficient anterior cruciate ligament (ACL). These PHMM tears have to be surgically addressed, however they remain a diagnostic challenge. Hence, this study aims to ev...
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| Format: | Article |
| Language: | English |
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Malaysian Orthopaedic Association
2023-03-01
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| Series: | Malaysian Orthopaedic Journal |
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| Online Access: | http://morthoj.org/2023/v17n1/ACL-deficient-knee.pdf |
| _version_ | 1797817578104553472 |
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| author | Gan G Toon DH Teo WWT Wee THA |
| author_facet | Gan G Toon DH Teo WWT Wee THA |
| author_sort | Gan G |
| collection | DOAJ |
| description | Introduction: A posterior horn medial meniscus (PHMM) tear subjects the knee to pathological stresses, especially in the setting of a deficient anterior cruciate ligament (ACL). These PHMM tears have to be surgically addressed, however they remain a diagnostic challenge. Hence, this study aims to evaluate the wave sign as an arthroscopic diagnostic aid for the PHMM tear which may be occult.
Materials and methods: This is a retrospective study of 61 consecutive patients
(62 ACL-deficient knees) who underwent arthroscopic primary ACL reconstruction between September 2017 and August 2018. We defined PHMM tears as tears located in the posterior one-third of the medial meniscus. Root tears and ramp lesions were included in our analysis. The arthroscopic findings were recorded after a comprehensive arthroscopic survey.
Results: In the sample of ACL-deficient knees, 44 (71.0%) had a concomitant medial meniscus tear. The most common location for the tear was in the posterior horn (81.8%). There were seven occult PHMM tears, not described by the radiologist or identified by the operating surgeon on the pre- operative magnetic resonance imaging. The wave sign was identified in 10 (16.1%) knees, all confirming the presence of the PHMM tear. A positive correlation was found between the presence of the wave sign and the PHMM tear. Conclusions: The wave sign has a statistically significant but weak positive correlation with the presence of the PHMM. We view the wave sign as a valuable arthroscopic cue to rule-in the presence of the PHMM tear in the ACL- deficient knee. |
| first_indexed | 2024-03-13T08:55:34Z |
| format | Article |
| id | doaj.art-97efbf1642a0406ea16e6831b5395ab4 |
| institution | Directory Open Access Journal |
| issn | 1985-2533 2232-111X |
| language | English |
| last_indexed | 2024-03-13T08:55:34Z |
| publishDate | 2023-03-01 |
| publisher | Malaysian Orthopaedic Association |
| record_format | Article |
| series | Malaysian Orthopaedic Journal |
| spelling | doaj.art-97efbf1642a0406ea16e6831b5395ab42023-05-29T03:23:53ZengMalaysian Orthopaedic AssociationMalaysian Orthopaedic Journal1985-25332232-111X2023-03-0117111111610.5704/MOJ.2303.013The Wave Sign Correlates with the Posterior Horn Medial Meniscus (PHMM) Tear in the Anterior Cruciate Ligament (ACL) Deficient KneeGan G0Toon DH1Teo WWT2Wee THA3Department of Orthopaedics, Khoo Teck Puat Hospital, SingaporeDepartment of Orthopaedics, Khoo Teck Puat Hospital, SingaporeDepartment of Orthopaedics, Khoo Teck Puat Hospital, SingaporeDepartment of Orthopaedics, Khoo Teck Puat Hospital, SingaporeIntroduction: A posterior horn medial meniscus (PHMM) tear subjects the knee to pathological stresses, especially in the setting of a deficient anterior cruciate ligament (ACL). These PHMM tears have to be surgically addressed, however they remain a diagnostic challenge. Hence, this study aims to evaluate the wave sign as an arthroscopic diagnostic aid for the PHMM tear which may be occult. Materials and methods: This is a retrospective study of 61 consecutive patients (62 ACL-deficient knees) who underwent arthroscopic primary ACL reconstruction between September 2017 and August 2018. We defined PHMM tears as tears located in the posterior one-third of the medial meniscus. Root tears and ramp lesions were included in our analysis. The arthroscopic findings were recorded after a comprehensive arthroscopic survey. Results: In the sample of ACL-deficient knees, 44 (71.0%) had a concomitant medial meniscus tear. The most common location for the tear was in the posterior horn (81.8%). There were seven occult PHMM tears, not described by the radiologist or identified by the operating surgeon on the pre- operative magnetic resonance imaging. The wave sign was identified in 10 (16.1%) knees, all confirming the presence of the PHMM tear. A positive correlation was found between the presence of the wave sign and the PHMM tear. Conclusions: The wave sign has a statistically significant but weak positive correlation with the presence of the PHMM. We view the wave sign as a valuable arthroscopic cue to rule-in the presence of the PHMM tear in the ACL- deficient knee.http://morthoj.org/2023/v17n1/ACL-deficient-knee.pdfkneearticular cartilageanterior-cruciate ligamentmeniscus |
| spellingShingle | Gan G Toon DH Teo WWT Wee THA The Wave Sign Correlates with the Posterior Horn Medial Meniscus (PHMM) Tear in the Anterior Cruciate Ligament (ACL) Deficient Knee Malaysian Orthopaedic Journal knee articular cartilage anterior-cruciate ligament meniscus |
| title | The Wave Sign Correlates with the Posterior Horn Medial Meniscus (PHMM) Tear in the Anterior Cruciate Ligament (ACL) Deficient Knee |
| title_full | The Wave Sign Correlates with the Posterior Horn Medial Meniscus (PHMM) Tear in the Anterior Cruciate Ligament (ACL) Deficient Knee |
| title_fullStr | The Wave Sign Correlates with the Posterior Horn Medial Meniscus (PHMM) Tear in the Anterior Cruciate Ligament (ACL) Deficient Knee |
| title_full_unstemmed | The Wave Sign Correlates with the Posterior Horn Medial Meniscus (PHMM) Tear in the Anterior Cruciate Ligament (ACL) Deficient Knee |
| title_short | The Wave Sign Correlates with the Posterior Horn Medial Meniscus (PHMM) Tear in the Anterior Cruciate Ligament (ACL) Deficient Knee |
| title_sort | wave sign correlates with the posterior horn medial meniscus phmm tear in the anterior cruciate ligament acl deficient knee |
| topic | knee articular cartilage anterior-cruciate ligament meniscus |
| url | http://morthoj.org/2023/v17n1/ACL-deficient-knee.pdf |
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