Patients with suspected meniscal tears: prevalence of abnormalities seen on MRI of 100 symptomatic and 100 contralateral asymptomatic knees

OBJECTIVE: The purpose of this study was to evaluate the prevalence of MR abnormalities of the knee on the symptomatic and contralateral asymptomatic sides in patients with suspected meniscal tears. SUBJECTS AND METHODS. One hundred patients (mean age, 42.7 years; range, 18-73 years) referred for suspected meniscal tears were prospectively examined with MRI of both knees when the contralateral knee was asymptomatic. The prevalence of various types of meniscal tears and other MR abnormalities was determined. RESULTS: Meniscal tears were found in 57 symptomatic knees and in 36 contralateral asymptomatic knees. In those 57 patients with a meniscal tear on the symptomatic side, the prevalence of asymptomatic tears in the contralateral side was 63% (36/57). Horizontal or oblique meniscal tears were found medially in 32 and laterally in 11 symptomatic knees, and medially in 29 and laterally in eight asymptomatic knees. Radial, vertical, complex, or displaced tears were found medially in 18 and laterally in five symptomatic knees, and medially in five and laterally in none of the asymptomatic knees. Collateral ligament abnormalities were found in 53 symptomatic knees and in six asymptomatic knees. Pericapsular soft-tissue abnormalities were found in 64 symptomatic and in 12 asymptomatic knees. Edema-like bone marrow abnormalities were found in 36 symptomatic and in three asymptomatic knees. CONCLUSION: Horizontal or oblique meniscal tears are frequently encountered in both asymptomatic and symptomatic knees and may not always be related to symptoms. However, radial, vertical, complex, or displaced meniscal tears and abnormalities of the collateral ligaments, pericapsular soft tissues, and bone marrow are found almost exclusively on the symptomatic side and appear to be clinically more meaningful.     

Lateral meniscal tears and their evolution in acute injuries of the anterior cruciate ligament of the knee Arthroscopic analysis

Arthroscopic diagnosis was used to determine the incidence of the most frequent injuries to the knee’s internal structures associated with ACL tear as well as ones without ACL tear. The most frequent finding associated with a recent ACL tear was the LM tear (72.7%). There is a statistically significant incidence of recent LM tear in knees with a recent ACL tear compared with recently injured knees without an ACL tear (P < 0.001). A statistically significant incidence of longitudinal LM tear was found in knees with a recent ACL tear compared with recently injured knees without an ACL tear (P < 0.001). Longitudinal tears were present in 63.6% of the knees with a recent ACL tear or in 87.5% of all knees with a recent LM tear. No statistically significant difference was found in the incidence of LM tear in the knees with a recent ACL tear compared to the incidence of LM tear in knees with an old ACL tear (P > 0.05). The posterior horn was most frequently injured (71.5% vs 64.0%). A significant difference between the findings in the various patient groups studied supports the hypothesis that longitudinal LM tears in an ACL-deficient knee do not involve secondary meniscal pathology but that their onset derives from a primary recent injury. Most probably, the recent LM lesion does not evolve in meniscal length and depth. This hypothesis needs thorough investigation. Received: 25 May 1996 Accepted: 7 April 1997     

How I diagnose meniscal tears on knee MRI

OBJECTIVE: The goal of this article is to summarize the literature about the diagnosis of meniscal tears on MRI including the normal appearance of the meniscus and the appearance of the various types of meniscal tears. In addition, I discuss my experience with the causes of errors in the MR diagnosis of meniscal abnormalities and the nuances of meniscal abnormalities that can mimic a meniscal tear. CONCLUSION: MRI is a highly accurate imaging method for diagnosing meniscal tears. To avoid errors in diagnosing meniscal tears, those interpreting MR examinations of the knee need to be aware of the attachments of the menisci and the normal variations in meniscal anatomy that may resemble a meniscal tear. In addition, by being aware of the patterns of meniscal tears, it is easier to diagnose the less common tears.     

Anomalous insertion of the medial meniscus into the anterior cruciate ligament: the MR appearance

The aim of this study was to determine the characteristic MR findings of the anomalous insertion of the medial meniscus (AIMM) into the anterior cruciate ligament (ACL), and to document potential pitfalls in its interpretation. We reviewed 1326 consecutive knee arthroscopic studies to identify patients with an AIMM. 30 knees of 26 patients (4 females, 22 males; average age, 31.3 years; range, 14-50 years) were included in this study. We evaluated the presence of an AIMM and analysed the MR findings, including the ACL attachment sites of the AIMMs, the absence of the transverse ligament, meniscal tears and a discoid meniscus. AIMMs were detected by MR imaging in 16 knees of 18 patients (60%, 18/30). The AIMMs showed a linear band with low signal intensity on T2 weighted sagittal images running parallel to the ACL. The AIMMs were inserted into the lower portion of the ACL in eight knees, the middle portion in five knees, and the intercondylar notch in five knees. Meniscal tears (10 medial, 10 lateral) were found in 20 knees of 16 patients. Six knees of five patients showed a discoid meniscus. 15 knees of 14 patients showed no transverse ligament on MR imaging. An AIMM has the potential to be misinterpreted as a meniscal tear, ACL tear or infrapatellar plica on knee MR imaging. Familiarity with the characteristic MR findings can aid in the detection of an AIMM into the ACL.     

Accuracy of MRI patterns in evaluating anterior cruciate ligament tears

 The purpose of this study was to determine the different patterns of anterior cruciate ligament (ACL) tears on MRI and the prevalence and accuracy of these patterns. Images were obtained on high-tesla and low-tesla units and the results compared to determine whether field strength affects the interpretation using the grading system. In 172 patients who underwent knee MRI (109 knees with high-tesla units and 63 knees with low-tesla units) and arthroscopy, there was a total of 91 arthroscopically proven ACL tears. Five patterns of ACL tears were observed and designated as type 1 (diffuse increase in signal on T2-weighted images and enlargement of the ligament, 48%); type 2 (horizontally oriented ACL, 21%); type 3 (nonvisualization of the ACL, 18%); type 4 (discontinuity of the ACL, 11%); and type 5 (vertically oriented ACL, 2%). The positive predictive value (PPV) for type 2, 4, and 5 patterns was 100% for both field strengths; for type 3 PPV was just above 80% for both field strengths. The PPV value for type 1 was 90% for the high-tesla unit and 79% for the low-tesla, unit, which was not statistically significant. Combining the results of both field strengths, the overall sensitivity and specificity were 93% and 89%, respectively. Arthroscopic results were also used to determine the association between meniscal and ACL tears. Only 13% of ACL tears were isolated, the rest being associated with meniscal tears. Forty-five percent of medial meniscal and 50% of lateral meniscal tears were associated with an ACL tear, and 94% of ACLs were torn when both menisci were torn.     

MR imaging of meniscal bucket-handle tears: a review of signs and their relation to arthroscopic classification

Our objective was to review the MR imaging signs of meniscal bucket-handle tears and assess the relevance of these signs to the arthroscopic classification of displaced meniscal tears. Forty-five menisci in 42 patients who had a diagnosis of bucket-handle tear either on MR imaging or on subsequent arthroscopy (in which Dandy's classification of meniscal tears was used) were retrospectively analyzed for MR imaging findings of double posterior cruciate ligament (PCL), fragment within the intercondylar notch, absent bow tie, flipped meniscus, double-anterior horn, and disproportional posterior horn signs. Arthroscopy, which was considered as the gold standard, revealed 41 bucket-handle tears (either diagnosed or not diagnosed by MR imaging) in 38 patients (33 males, 5 females). There was a stastistically significant male preponderance for the occurrence of meniscal bucket-handle tears. Overall, sensitivity and positive predictive value of MR imaging for the detection of meniscal bucket-handle tears were calculated as 90%. Common MR imaging signs of meniscal bucket-handle tears in arthroscopically proven cases of such tears were the fragment in the notch and absent bow tie signs (98% frequency for each). Double-PCL, flipped meniscus, double-anterior horn, and disproportional posterior horn signs, however, were less common (32, 29, 29, and 27%, respectively). An arthroscopically proven bucket-handle tear was found in all patients who displayed at least three of the six MR imaging signs of meniscal bucket-handle tears. The presence of three or more MR imaging signs of meniscal bucket-handle tears is highly suggestive of this condition. Electronic Publication     

外伤性膝关节前外侧韧带损伤的MR影像特征及相关性分析

目的探讨外伤所致膝关节前外侧韧带损伤病人的MR影像特征,并分析其与前交叉韧带撕裂、外侧半月板撕裂及骨挫伤的相关性,为深入研究前外侧韧带对膝关节稳定性的作用提供可靠依据。方法回顾性分析2016年1月—2017年2月间因外伤进行膝关节MRI检查的320例病人(共321膝)的影像资料。采用美国GE公司生产的Signa HDe 1.5 T MR扫描设备,分别行膝关节斜矢状面T1WI、质子密度加权成像(PDWI)和冠状面、横断面PDWI扫描。根据前外侧韧带的完整性和损伤部位对所有病人进行分类统计。采用独立性卡方检验对前外侧韧带撕裂与前交叉韧带撕裂、外侧半月板撕裂及骨挫伤的相关性进行分析。结果全部病人膝关节MR影像均可显示前外侧韧带,显示率为100%。151/321膝(47.0%;95%CI为41.6%~52.5%)存在前外侧韧带损伤,其中累及胫骨部、股骨部及半月板部的分别为97膝、96膝及65膝。前交叉韧带撕裂158膝,外侧半月板撕裂98膝,股骨外侧髁挫伤58膝,外侧胫骨平台挫伤71膝,分别与前外侧韧带撕裂具有相关性(均P0.001)。结论 MRI检查可以很好地显示前外侧韧带解剖及其损伤情况。膝关节前外侧韧带损伤与前交叉韧带撕裂、外侧半月板撕裂及膝外侧骨挫伤具有相关性。     

Meniscal tears with fragments displaced in notch and recesses of knee: MR imaging with arthroscopic comparison

PURPOSE: To retrospectively evaluate magnetic resonance (MR) imaging for the depiction of meniscal tears with partially detached meniscal fragments displaced in the intercondylar notch or in the meniscal recesses of the knee. MATERIALS AND METHODS: The institutional review board required neither its approval nor informed patient consent for the retrospective review of patient data; however, informed patient consent had been obtained before the MR imaging examinations were performed. The presence of meniscal tears with notch and recess fragments was determined at MR imaging and at subsequent arthroscopy in 101 consecutive knees to determine the value of MR imaging for the depiction of these lesions. Initial reports were reviewed to evaluate results of initial interpretations. MR images were retrospectively analyzed to determine the value of several MR image signs for the detection of displaced tears with notch or recess fragments. RESULTS: At arthroscopy, 37 (41%) of 91 torn menisci had partially detached fragments. Twenty-six torn menisci had notch fragments, and 14 had recess fragments; three torn menisci had one notch and one recess fragment each. At initial MR image analysis, 38 (36%) of 105 torn menisci had partially detached fragments. Twenty-eight torn menisci had notch fragments, and 13 had recess fragments; one torn meniscus had two recess fragments, and three torn menisci had one notch and one recess fragment each. At initial analysis, sensitivities and specificities were, respectively, 69% and 94% for detection of tears with notch fragments and 71% and 98% for detection of tears with recess fragments. At retrospective analysis of sagittal MR images, the presence of at least one sign indicative of meniscal tear with a notch fragment had sensitivities and specificities, respectively, of 65% and 78% for observer 1 and 77% and 73% for observer 2. The presence of at least one sign indicative of a meniscal tear with a recess fragment had sensitivities and specificities, respectively, of 64% and 77% for observer 1 and 64% and 76% for observer 2. CONCLUSION: Meniscal tears with notch and recess fragments are frequently seen at arthroscopy and can be depicted at knee MR imaging with moderate sensitivity and high specificity.     

膝关节半月板损伤的MRI与关节镜对照研究

目的评价MRI在膝关节半月板撕裂诊断和评级中的价值。方法参照Mesgarzadeh标准对76位患者78个撕裂半月板的MR影像作回顾性分析,3位MRI主治医师在不知道关节镜检查结果的情况下独自阅片,按Mesgarzadeh的分级标准确定半月板撕裂的类型并记录评定结果,包括联合的前交叉韧带撕裂。结果MRI诊断半月板撕裂的敏感性和特异性分别为92%和87%,Ⅵ型是半月板撕裂中最常见的类型,尤其在发生移位的半月板撕裂中最常见。结论MRI是半月板撕裂伤和交叉韧带损伤的可靠诊断工具。     

Characteristics of displaceable and nondisplaceable meniscal tears at kinematic MR imaging of the knee

PURPOSE: To prospectively determine if kinematic magnetic resonance (MR) imaging of the knee may demonstrate displacement of menisci with tears and, if so, to characterize displaceable and nondisplaceable meniscal tears. MATERIALS AND METHODS: The study was approved by the hospital's review board, and informed consent was obtained. Forty-two patients (30 men, 12 women; mean age, 36.9 years) with 43 arthroscopically documented meniscal tears visible at 1.5-T MR imaging underwent kinematic MR imaging with an open-configuration 0.5-T MR imager with their knees in supine neutral, supine with 90 degrees flexion and external or internal rotation, and upright weight-bearing positions. Analysis of meniscal movement was performed in different knee positions in the coronal MR imaging plane. Meniscal displacement--that is, meniscal movement of 3 mm or more (in the medial direction for the medial meniscus, in the lateral direction for the lateral meniscus)--was compared with the patient's pain level as assessed with a visual analog scale by using analysis of variance. RESULTS: Between the different knee positions, meniscal displacement of 3 mm or more (displaceable meniscal tears) was noted in 18 (42%) of 43 menisci with tears. Simultaneous occurrence of grade II or III ipsilateral collateral ligament lesions was present in all 18 displaceable meniscal tears, whereas a normal-appearing collateral ligament or collateral ligament lesion (grade I) was present in 22 of 25 nondisplaceable tears (P < .05). Displaced menisci most commonly had complex, radial, or longitudinal tear configurations (16 of 18, 89%). Patients with displaceable meniscal tears had significantly more pain than did patients with nondisplaceable meniscal tears (P < .001), independent of the concomitant knee abnormalities. CONCLUSION: Displaceable meniscal tears usually have longitudinal, radial, or complex configurations; such tears are associated with substantial ipsilateral collateral ligament lesions and pain.     

Meniscal extrusion in young athletes: associated knee joint abnormalities

OBJECTIVE: The objective of our study was to assess the rate of meniscal extrusion and its connection with common meniscal and joint abnormalities. MATERIALS AND METHODS: MR signs of meniscal extrusion were evaluated retrospectively in 24 rugby and soccer players (40 knees) who are currently free of pain in the knee, impaired mobility, and joint swelling. The control group consisted of 23 consecutive active individuals (36 knees) with no history of knee problems. The criterion for extrusion of the meniscus was defined as a distance of 3 mm or more between the peripheral border of the meniscus and the edge of the tibial plateau measured on coronal images. RESULTS: Forty-eight percent of the athletes' knees and 30% of the control subjects' knees showed evidence of meniscal extrusion. Among the athletes, a significant association between meniscal extrusion and joint effusion (11 cases), meniscal tears (seven cases), and anterior cruciate ligament (ACL) tear (four cases) was found (p < or = 0.004). In the control group, no significant association was found between meniscal extrusion and joint effusion (three cases), meniscal tears (four cases), and ACL tears (two cases) (p = 1.00). A significant association was not found between degenerative change and meniscal extrusion in either the athletes (p = 0.23) or the control subjects (p = 1.00). The most commonly associated knee abnormality was joint effusion in 73% of knees with meniscal extrusion in athletes. CONCLUSION: Meniscal extrusion is a common finding on MRI of athletes' knees. Meniscal extrusion in association with meniscal tear and joint effusion is postulated as a significant injury in athletes and its recognition as such in this group is important because it may prompt orthopedic intervention.     

Bucket handle tears of the medial meniscus: meniscal intrusion rather than meniscal extrusion

Objective To determine the frequency of medial meniscal extrusion (MME) versus “medial meniscal intrusion” in the setting of bucket handle tears. Images were evaluated for previously reported risk factors for MME, including: medial meniscal root tear, radial tear, degenerative joint disease and joint effusion. Methods Forty-one consecutive cases of bucket handle tear of the medial meniscus were reviewed by consensus by two musculoskeletal radiologists. Imaging was performed using a 1.5 GE Signa MR unit. Patient age, gender, medial meniscal root integrity, MME, medial meniscal intrusion, degenerative joint disease, effusion and anterior cruciate ligament (ACL) tear were recorded. Results Thirteen females and 27 males (age 12–62 years, median=30 years) were affected; one had bucket handle tear of each knee. Effusion was small in 13, moderate in 9 and large in 18. Degenerative joint disease was mild in three, moderate in two and severe in one. 26 ACL tears included three partial and three chronic. Medial meniscal root tear was complete in one case and partial thickness in two. None of the 40 cases with an intact or partially torn medial meniscal root demonstrated MME. MME of 3.1 mm was seen in the only full-thickness medial meniscal root tear, along with chronic ACL tear, moderate degenerative joint disease and large effusion. Medial meniscal intrusion of the central bucket handle fragment into the intercondylar notch was present in all 41 cases. Conclusion Given an intact medial meniscal root in the setting of a “pure” bucket handle tear, there is no MME.     

Prevalence of meniscal radial tears of the knee revealed by MRI after surgery

OBJECTIVE: Meniscal resection decreases the ability of the meniscus to evenly distribute forces placed on it. These forces are oriented centrifugally on the meniscus by normal weight-bearing and are distributed by circumferentially oriented fibers. This alteration may predispose the knee to radial tears after surgery. SUBJECTS AND METHODS: One of three musculoskeletal radiologists prospectively interpreted 100 consecutive postoperative MRI examinations of the knee. A prospective MRI report was generated for the referring orthopedic surgeon, and prospective MRI interpretations were correlated with arthroscopic findings (n = 63). MRI examinations on those patients who underwent second-look arthroscopy were retrospectively reviewed by three musculoskeletal radiologists who reached a consensus on the prevalence of new postoperative meniscal radial tears. MRI criteria for radial tear diagnosis were used as outlined by Tuckman et al.: truncation, abnormal morphology, lack of continuity, absence of the meniscus, or any combination of those criteria on one or more MR images. An additional criterion used was abnormal increased signal in that area on T2-weighted images. RESULTS: Thirty-two of the 100 patients had meniscal radial tears on prospective MRI interpretations. In 29 of these 32 patients, second-look arthroscopy confirmed meniscal radial tears in the areas described on the MRI examinations. Five additional radial tears were shown on second-look arthroscopy that were not seen on prospective MRI interpretations. Two of those additional five radial tears were seen on consensus retrospective MRI review. CONCLUSION: In this study, a 32% prevalence of meniscal radial tears in the postoperative knee was present on prospective MRI interpretations as opposed to a reported 14% prevalence in the nonoperated knee. Meniscal resection decreases the ability of the meniscus to evenly distribute forces placed on it. This circumstance may increase the prevalence of meniscal radial tears in the postoperative knee. New meniscal radial tears are common in patients presenting with pain after knee surgery.     

Acute and chronic tears of the anterior cruciate ligament: differential features at MR imaging

To evaluate the differential features of acute and chronic tears of the anterior cruciate ligament at magnetic resonance (MR) imaging, the authors performed a retrospective evaluation of findings in 81 MR examinations correlated with results at arthroscopy. Intact anterior cruciate ligaments (ACLs) were present in 29 patients; acute complete ACL tears, in 22; and chronic complete ACL tears, in 30. Acute tears were accurately distinguished from intact ligaments and were characterized by the presence of edema. Chronic tears had a more variable appearance: Nine (30%) were depicted at MR as intact bands with low signal intensity that bridged the expected origin and insertion of the ACL. This appearance is likely due to the presence of bridging fibrous scars within the intercondylar notch. Five of these nine cases were correctly characterized as chronically torn because of the presence of focal angulation. In four of these nine cases the scarred fragments produced a relatively straight band that mimicked an intact ligament. Although chronic and acute ACL tears usually have distinct findings at MR, a chronic tear will occasionally be difficult to distinguish from an intact ligament.     

Meniscus tears that can be left in situ, with or without trephination or synovial abrasion to stimulate healing

To determine which meniscus tears to leave in situ, the clinician must know whether the meniscus tear is degenerative or nondegenerative, stable or unstable, in an anterior cruciate ligament (ACL)-stable or ACL-unstable knee, and whether it is in the medial or lateral compartment. Symptomatic medial meniscus tears in ACL-intact knees are almost always degenerative in nature and should be removed. Generally, the only type of medial meniscus that can be left in situ is a peripheral, vertical, nondegenerative tear, but these tears are not displaceable, are asymptomatic, and are usually seen in a patient with an ACL tear. In the lateral compartment, most tears can be left in situ and the only tears that need to be repaired are displaceable tears that extend anterior to the popliteus tendon. Although many meniscus repair techniques and fixation devices are available, all factors related to healing and stability should be considered to determine treatment.     

膝关节半月板撕裂磁共振成像与关节镜对照研究

目的分析磁共振成像（MRI）在膝关节半月板撕裂诊断中的价值。方法分析168例（共计336个半月板）临床疑诊半月板损伤患者,依次在1周内行磁共振（MR）和关节镜检查,对比MR和关节镜检查结果,探讨MRI对膝关节半月板撕裂诊断符合率。结果以关节镜为参考标准,168例（共计336个半月板）中MRI诊断半月板撕裂敏感性96．9％,特异性为87．5％,准确性为92．5％,假阳性率为12．5％,假阴性率3．1％,MRI具有术前诊断价值。结论MRI诊断半月板撕裂具有很高准确性,但仍有一定的假阳性与假阴性。     

Simultaneous bucket handle tear of both medial and lateral menisci of a knee with chronic anterior cruciate ligament deficiency

Bucket handle meniscus tears constitute about 10% of all meniscal tears. Bucket handle tears of medial meniscus is three times more than lateral meniscus. Most of these tears are associated with anterior cruciate ligament (ACL) deficiency. Lateral meniscus lesions are more common with acute ACL deficiency, where medial meniscus lesions are more associated with chronic ACL deficiency. We identified bucket handle tears of each meniscus of a 30-year-old male patient while performing diagnostic arthroscopy during ACL reconstruction procedure. We present an ACL deficient knee with bucket handle tears of medial and lateral meniscus of the same knee and discuss the treatment.     

膝关节半月板撕裂的MRI（与手术,关节镜对照研究）

目的：研究半月板内信号接触关节面的特定型式与半月板撕裂的关系。材料和方法：分析了９８例临床怀疑半月板撕裂病人的膝关节ＭＲ资料，并与手术或关节镜检查结果进行对照研究。结果：信号接触关节面的半月板发生撕裂的机率明显高于不接触和可能接触的半月板（Ｐ＜００１）。信号可能接触关节面的半月板与不接触的半月板发生撕裂的机率无显著性差异（Ｐ＞００５）。当一层以上图像显示半月板内信号接触关节面时，发生半月板撕裂的机率在９０％以上；而只有一层图像显示半月板内信号接触关节面时，发生半月板撕裂的机率在内侧半月板为５０％，外侧半月板为３３％。半月板撕裂最好发的部位是半月板的后角。结论：当半月板内信号与关节面无接触或可能接触时，发生半月板撕裂的可能性均较小；当只有一层图像显示半月板内信号接触关节面时，诊断为半月板可能撕裂较妥，当一层以上图像显示信号接触关节面时，诊断为月板撕裂较可靠     

Magnetic resonance diagnosis of meniscal tears in patients with acute anterior cruciate ligament tears

OBJECTIVE: To evaluate the accuracy of magnetic resonance imaging in the diagnosis of meniscal tear in patients with acute anterior cruciate ligament tears. METHODS: Magnetic resonance images obtained from 41 patients imaged within 6 weeks of injury who had acute anterior cruciate ligament tears identified at arthroscopy were retrospectively reviewed for meniscal tear. RESULTS: With MR imaging the sensitivity, specificity and accuracy for diagnosing meniscal tears in the presence of acute anterior cruciate ligament tears were 71%, 93%, and 88%; for the lateral meniscal tears were 57%, 100% and 85%; and for the medial meniscal tears were 100%, 88%, 90%. All false negative cases (n = 6) involved the posterior horn of the lateral meniscus. CONCLUSION: In the presence of acute anterior cruciate ligament tears, MRI imaging has relatively low sensitivity for detecting meniscal tears due to missed tears in the lateral meniscus.     

Patterns of meniscal injury with acute anterior cruciate ligament tears

One hundred two patients underwent an arthrotomy for the primary repair of an acute ACL tear with or without an associated collateral ligament injury. The mean age was 23 years. Forty-seven patients (46%) had meniscal injuries. Meniscal injuries were found in 41% of Group I patients (isolated ACL injuries) and in 54% of Group II patients (injured ACL/collateral ligaments). Twenty-eight medial and 22 lateral meniscal tears were noted. Twenty-six of the 50 meniscal tears (52%) were sutured in an attempt to repair the menisci. Of these, 20 of the medial (71%), and 6 of the lateral (27%) meniscal injuries were sutured. No patients in this series required a total meniscectomy. A thorough evaluation of the menisci is mandatory in knees with an acutely injured ACL.