title: Predictive value of painful popping for a posterior root tear of the medial meniscus in middle-aged to older Asian patients.
abstract: OBJECTIVE
  The purpose of this study was to determine the accuracy, sensitivity, specificity, and predictive values of a single event of painful popping in the presence of a posterior root tear of the medial meniscus in middle-aged to older Asian patients.
  
  
  METHODS
  We conducted a retrospective review of medical records of 936 patients who underwent arthroscopic surgeries for an isolated medial meniscus tear between January 2000 and December 2010. There were 332 men and 604 women with a mean age of 41 years (range, 25 to 66 years). The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of a painful popping sensation for a posterior root tear of the medial meniscus were calculated.
  
  
  RESULTS
  Arthroscopy confirmed the presence of posterior root tears of the medial menisci in 237 of 936 patients (25.3%). A single event of a painful popping sensation was present in 86 of these 936 patients (9.1%). Of these 86 patients with a painful popping sensation, 83 (96.5%) were categorized as having an isolated posterior root tear of the medial meniscus. The positive predictive value of a painful popping sensation in identifying a posterior root tear of the medial meniscus was 96.5%, the negative predictive value was 81.8%, the sensitivity was 35.0%, the specificity was 99.5%, and the diagnostic accuracy was 77.9%.
  
  
  CONCLUSIONS
  A single event of painful popping can be a highly predictive clinical sign of a posterior root tear of the medial meniscus in the middle-aged to older Asian population. However, it has low sensitivity for the detection of a posterior root tear of the medial meniscus.
  
  
  METHODS
  Level IV, therapeutic case series.
authors: Department of Orthopedic Surgery, Inje University, Ilsanpaik Hospital, Ilsan, South Korea.
authors: Ji-Hoon
authors: JH
authors: Bae
authors: Nak Hwan
authors: NH
authors: Paik
authors: Gyu-Won
authors: GW
authors: Park
authors: Jung-Ro
authors: JR
authors: Yoon
authors: Dong-Ju
authors: DJ
authors: Chae
authors: Jae Ho
authors: JH
authors: Kwon
authors: Jong In
authors: JI
authors: Kim
authors: Kyung-Wook
authors: KW
authors: Nha
mesh_terms: D000328:Adult; D000368:Aged; D018771:Arthralgia / Q000209:etiology*; D001182:Arthroscopy; D044466:Asian People; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D000070600:Tibial Meniscus Injuries