Medial extrusion of the posterior segment of medial meniscus is a sensitive sign for posterior horn tears

Background: To evaluate medial extrusion of the posterior segment of the medial meniscus in posterior horn tears. Methods: This study enrolled 72 patients without medial meniscal tears (group N), 72 patients with medial meniscal tears without posterior horn tears (group PH -), 44 patients with posterior horn tears of the medial meniscus (group PH +). All meniscal tears were confirmed by arthroscopy. Medial extrusion of the middle segment and the posterior segment was measured on coronal MRIs. Results: Extrusions of both middle and posterior segments in groups PH and PH + (middle segment; 2.94 +/- 1.51 mm for group PH and 3.75 +/- 1.69 mm for group PH +, posterior segment; 1.85 +/- 1.82 mm for group PH and 4.59 +/- 2.74 mm for group PH +) were significantly larger than those in group N (middle segment; 2.04 +/- 1.20, posterior segment; 121 +/- 1.86). Both indicators of extrusion in group PH + were larger than those in group PH -. In the early OA category, neither middle nor posterior segment in group PH - extruded more than in group N. However, only the posterior segment in group PH + extruded significantly more than in group N. Multiple lineal regression analyses revealed that posterior segment extrusion was strongly correlated with the posterior horn tears (p < 0.001) among groups PH - and PH +. Conclusion: The newly presented indicator for extrusion of the posterior segment of the medial meniscus is associated with posterior horn tears in comparison with the extrusion of the middle segment, especially in the early stages of osteoarthritis. Level of Evidence: Level II - Diagnostic Study (C) 2013 Elsevier B.V. All rights reserved.