Evidence map›Paper›PMID 39865480›Full record

ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2025

Combined use of cleft and truncated triangle signs helps improve the preoperative MRI diagnosis of lateral meniscus posterior root tears in patients with ACL injuries.

Aritoshi Yoshihara, Caroline Mouton, Renaud Siboni, Tomomasa Nakamura, Ichiro Sekiya, Hideyuki Koga, Romain Seil, Yusuke Nakagawa

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Aritoshi YoshiharaDepartment of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, Tokyo, Japan.
Caroline MoutonDepartment of Orthopaedic Surgery, Centre Hospitalier Luxembourg-Clinique d'Eich, Luxembourg, Luxembourg.
Renaud SiboniDepartment of Orthopaedic Surgery, Reims University Hospital, Reims, France.
Tomomasa NakamuraDepartment of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, Tokyo, Japan.
Ichiro SekiyaCenter for Stem Cell and Regenerative Medicine, Institute of Science Tokyo, Tokyo, Japan.
Hideyuki KogaDepartment of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, Tokyo, Japan.
Romain SeilDepartment of Orthopaedic Surgery, Centre Hospitalier Luxembourg-Clinique d'Eich, Luxembourg, Luxembourg.
Yusuke NakagawaDepartment of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, Tokyo, Japan.ORCID http://orcid.org/0000-0003-0170-9743

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis study aimed to investigate whether combining the analysis of different magnetic resonance imaging (MRI) signs enhances the diagnostic accuracy of lateral meniscus posterior root tears (LMPRTs) in patients with anterior cruciate ligament (ACL) injuries. We hypothesised that analysing the cleft, ghost and truncated triangle signs and lateral meniscus extrusion (LME) measurement together would improve the preoperative MRI-based diagnosis of LMPRTs.

methodsThis retrospective study used prospectively collected registry data from two academic centres, including patients undergoing primary or revision ACL reconstruction (ACLR) and LMPRT repair. The control group included age- and sex-matched (1:1) patients undergoing ACLR without any lateral meniscus tears. LME (mm) and the presence of cleft, ghost and/or truncated triangle signs were evaluated using preoperative MRI.

resultsIn total, 252 patients (126 per group) were included. Individually, the cleft and truncated triangle signs achieved the highest sensitivity (60% and 62%, respectively) and accuracy (>89%). The presence of either sign increased sensitivity to 79% and enabled the correct classification of 93% of ACL injuries as having or not having an LMPRT, with high specificity (95%) and good positive predictive value (74%). This combination was considered the most efficient in reducing false positives and false negatives. The LME (cutoff value: 2.2 mm) and ghost sign had lower sensitivities (50% and 14%, respectively) and accuracies (83% and 87%) and were not part of the optimal combination.

conclusionThe cleft and/or truncated triangle signs on preoperative MRI reliably detected 79% of LMPRTs in this cohort, with high specificity (95%) and good positive predictive value (74%). This combination provides an effective method for achieving reasonable sensitivity while minimising false positives, aiding surgeons in preoperative diagnosis and planning for LMPRT repair. LEVEL OF EVIDENCE: Level III.

Indexed as

Anterior Cruciate Ligament InjuriesMagnetic Resonance ImagingTibial Meniscus InjuriesAdolescentAdultAnterior Cruciate Ligament ReconstructionFemaleHumansMaleMiddle AgedPreoperative CareRetrospective StudiesSensitivity and SpecificityYoung Adultcleft signghost signlateral meniscus extrusionlateral meniscus posterior root teartruncated triangle sign

Identifiers

PMID39865480
PMCPMC12205407

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.