• OBJECTIVE
    • Displaced fragments in meniscal flap tears may be challenging to detect radiologically but are clinically relevant for treatment planning. This study aimed to characterize fragment migration patterns on MRI and evaluate associated intra-articular pathologies.
  • METHODS
    • In this retrospective analysis of 89 knee MRIs performed between January 2018 and May 2022, patients with confirmed meniscal flap tears were assessed for tear location, fragment displacement direction, and associated findings, including cartilage defects, ligament injuries, bone marrow edema, osteophytes, osteochondral lesions, and joint effusion. Statistical associations between tear features and accompanying pathologies were evaluated.
  • RESULTS
    • Inferior coronary recess was the most frequent displacement site, especially in medial tears (68.8%, P=0.007). Medial tears more often had cartilage defects (66.3%, P=0.024) and osteochondral lesions (55.0%, P=0.015). Posterior horn involvement predominated, and ACL tears were strongly associated with intercondylar notch displacement (77.8%, P=0.001).
  • CONCLUSION
    • Meniscal flap tears are most commonly located in the posterior horn of the medial meniscus and tend to displace into the inferior coronary recess. Their frequent association with cartilage damage, osteochondral lesions, and ACL injuries underscores the importance of careful MRI evaluation to support surgical decision-making.