Meniscal Comma Sign Responds to Partial Meniscectomy Despite Increased Levels of Arthritis.

Purpose: To compare the outcomes of patients undergoing partial meniscectomy preoperatively identified with the "meniscal comma sign" with those undergoing meniscectomy with other tear patterns. Methods: Patients with meniscal "comma sign," as indicated by a query of magnetic resonance imaging reports, were screened using the search terms "meniscotibial recess," "meniscus perched over the medial tibial margin," or other search terms by radiologists between January 2008 and November 2019. Patients were matched and chart review was done for demographics, revision surgery, and progression to total knee arthroplasty. Radiographs were used for osteoarthritis grading using the Kellgren-Lawrence (KL) scoring system. Preoperative and postoperative International Knee Documentation Committee, Knee Injury and Osteoarthritis Outcome Score, Lysholm, and Short Form 12-item Survey scores were collected. Results: A total of 406 patients met inclusion (comma sign = 197; control group = 209). The control group had an increased duration of symptoms at the initial visit ( Conclusions: Patients presenting with preoperative findings of meniscal comma sign fare similarly to those that do not. Patients with this meniscal injury tend to have more advanced grading of osteoarthritic changes in the knee at presentation and seek care earlier than those without. Arthroscopic meniscectomy is a good treatment option for patients with a meniscal fragment in the meniscotibial recess and shows outcomes comparable with those with other tear patterns. Level of Evidence: Level III, retrospective cohort.