0:00

So in this woman,

0:02

she's been having pain for one year,

0:04

chronic medial knee pain.

0:07

And the reason for the pain is a complex

0:10

flap tear of the medial meniscus.

0:14

The tear propagates all the way

0:16

from the root insertion.

0:18

We can see here the posterior cruciate ligament.

0:20

That's the root insertion of the medial meniscus,

0:23

and it travels through the posterior

0:25

horn into the body segment.

0:29

The main component of this complex flap tear is a

0:33

horizontal component that is propagating

0:38

all the way across the posterior horn

0:41

into the body segment.

0:43

We see fluid-like signal on these fluid-sensitive

0:46

sequences, extending from the joint space through

0:51

the flap into the pericapsular soft tissue.

0:54

So this patient has this small parameniscal cyst.

1:00

The presence of fluid within the flaps of the

1:05

meniscus, the superior and inferior flaps,

1:08

is indicative of instability and places this

1:12

patient at risk for mechanical symptoms.

1:16

These patients present typically with clicking,

1:20

popping, locking of the knee,

1:22

because the flap moves away from the donor side.

1:27

They tend to have also associated biomechanical

1:32

impact into the cartilage.

1:34

So, we need to check the cartilage very carefully

1:37

for the presence of chondral injuries

1:40

associated with it.

1:41

This patient has some surface irregularity

1:44

right adjacent to the tear.

1:46

So, in summary,

1:47

complex tear with a dominant horizontal component,

1:51

outlined by fluid, extending across the

1:55

root insertion into the body segment,

1:58

and then with these parameniscal cysts,

2:01

very typical of horizontal components

2:04

in meniscal tearing.