title: Root avulsion of the posterior horn of the medial meniscus in skeletally immature patients.
abstract: BACKGROUND
  Meniscal root avulsion has been predominantly reported in an adult population but little is known about this meniscal lesion in children and adolescents.
  
  
  OBJECTIVE
  The of this article is to describe the clinical symptoms and a new MRI sign of a medial meniscus posterior root avulsion in skeletally immature patients, and to report the arthroscopic procedure for its reinsertion in the presence of open physes.
  
  
  METHODS
  We report two skeletally immature patients who had a medial meniscus posterior root avulsion [MMPRA]. Diagnosis of a MMPRA was suspected on MRI by intense T2 hypersignal located at the postero-medial part of the tibial plateau reflecting trabecular bone oedema ("Bone bruise") at the level of the medial meniscal posterior root attachment. Arthroscopic reduction and fixation of the posterior root of the medial meniscus with transosseous sutures was performed. The patients returned to sport at the end of 6 months without residual symptoms. At one year, the radiographs showed no modification of the physis. Healing of the medial meniscal posterior root was noted on MRI.
  
  
  CONCLUSIONS
  In a skeletally immature patient it is important that this rare meniscal lesion is diagnosed early and adequately treated. We emphasize the importance of the indirect MRI signs that can lead a clinician to suspect the diagnosis of MMPRA. The aim of the surgery was to restore the anatomical footprint of the meniscal root and to re-establish its function thus preventing future chondral damage without damage to the tibial physeal growth plate.
  
  
  METHODS
  Level IV.
authors.affiliation: Hôpital Privé Jean Mermoz, Centre Orthopédique Santy, 24 Avenue Paul Santy, 69008 Lyon, France.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Sonnery-Cottet
authors.affiliation: Hôpital Privé Jean Mermoz, Centre Orthopédique Santy, 24 Avenue Paul Santy, 69008 Lyon, France.
authors.forename: Rafael
authors.initials: R
authors.lastname: Mortati
authors.affiliation: Hôpital Privé Jean Mermoz, Centre Orthopédique Santy, 24 Avenue Paul Santy, 69008 Lyon, France.
authors.forename: Pooler
authors.initials: P
authors.lastname: Archbold
authors.affiliation: Hôpital Privé Jean Mermoz, Centre Orthopédique Santy, 24 Avenue Paul Santy, 69008 Lyon, France.
authors.forename: François
authors.initials: F
authors.lastname: Gadea
authors.affiliation: Hôpital Privé Jean Mermoz, Centre Orthopédique Santy, 24 Avenue Paul Santy, 69008 Lyon, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Clechet
authors.affiliation: Hôpital Privé Jean Mermoz, Centre Orthopédique Santy, 24 Avenue Paul Santy, 69008 Lyon, France. Electronic address: mathieu.thaunat@yahoo.fr.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Thaunat
mesh_terms: D000293:Adolescent; D001182:Arthroscopy / Q000379:methods; D001265:Athletic Injuries / Q000175:diagnosis* / Q000601:surgery; D002357:Cartilage Diseases / Q000175:diagnosis* / Q000601:surgery; D002648:Child; D006801:Humans; D007718:Knee Injuries / Q000175:diagnosis* / Q000601:surgery; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D000070600:Tibial Meniscus Injuries
keywords: Arthroscopy; Knee; Meniscus root repair; Open physis