{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T03:59:29Z","timestamp":1793073569643,"version":"4.5.0"},"reference-count":32,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2022,5,4]],"date-time":"2022-05-04T00:00:00Z","timestamp":1651622400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2022,5,4]],"date-time":"2022-05-04T00:00:00Z","timestamp":1651622400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2022,5,4]],"date-time":"2022-05-04T00:00:00Z","timestamp":1651622400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>This study aimed to evaluate changes in the cleft width, defined as the distance between the lateral edge of the medial tibial plateau and that of the medial meniscus (MM) posterior root, using open magnetic resonance imaging (MRI) in patients with MM posterior root tear (MMPRT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study included 25 patients (20 women and 5\u00a0men; mean age: 65.2 years) who were diagnosed with MMPRT and underwent pullout repair. Upon coronal imaging, the cleft width was evaluated at the 10\u00b0 and 90\u00b0 flexed knee positions. The difference in the cleft width (defined as the cleft width at 90\u00b0 minus the cleft width at 10\u00b0) was also calculated. Upon sagittal imaging, the MM posterior extrusion (MMPE) at 90\u00b0 was also evaluated. Separate univariate linear regression models were used to determine the association between the time from injury to MRI and radiographic measurements.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean cleft width at 10\u00b0 and 90\u00b0 was 4.9\u2009\u00b1\u20092.6\u00a0mm and 7.4\u2009\u00b1\u20093.7\u00a0mm, respectively; the mean difference in cleft width was 2.5\u2009\u00b1\u20091.5\u00a0mm, and the mean MMPE at 90\u00b0 was 3.7\u2009\u00b1\u20091.3\u00a0mm. There was a significant difference in cleft width at 10\u00b0 and 90\u00b0 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). The time from injury to MRI was significantly associated with the cleft width at 10\u00b0 (<jats:italic>R<\/jats:italic>\u2009=\u20090.42; <jats:italic>p<\/jats:italic>\u2009=\u20090.023), cleft width at 90\u00b0 (<jats:italic>R<\/jats:italic>\u2009=\u20090.59; <jats:italic>p<\/jats:italic>\u2009=\u20090.002), the difference in the cleft width (<jats:italic>R<\/jats:italic>\u2009=\u20090.62; <jats:italic>p<\/jats:italic>\u2009=\u20090.008), and MMPE at 90\u00b0 (<jats:italic>R<\/jats:italic>\u2009=\u20090.53; <jats:italic>p<\/jats:italic>\u2009=\u20090.008).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study demonstrates that the cleft width is significantly larger during knee flexion than during knee extension. Increased cleft width during knee flexion (\u201cgraben\u201d sign) may help diagnose MMPRT, especially in cases where the cleft sign is unclear during knee extension.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>III.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-022-06983-8","type":"journal-article","created":{"date-parts":[[2022,5,4]],"date-time":"2022-05-04T12:03:57Z","timestamp":1651665837000},"page":"3726-3732","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Increased cleft width during knee flexion is useful for the diagnosis of medial meniscus posterior root tears"],"prefix":"10.1002","volume":"30","author":[{"given":"Takaaki","family":"Hiranaka","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Okayama University Hospital 2\u20105\u20101 Shikatacho, Kitaku 700\u20108558 Okayama Japan"},{"name":"<!--<label>2<\/label>--> Department of Orthopaedic Surgery Ako Central Hospital 52\u20106 Sohmon\u2010cho 678\u20100241 Ako Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5647-9132","authenticated-orcid":false,"given":"Takayuki","family":"Furumatsu","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Okayama University Hospital 2\u20105\u20101 Shikatacho, Kitaku 700\u20108558 Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinichi","family":"Miyazawa","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Okayama University Hospital 2\u20105\u20101 Shikatacho, Kitaku 700\u20108558 Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keisuke","family":"Kintaka","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Okayama University Hospital 2\u20105\u20101 Shikatacho, Kitaku 700\u20108558 Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naohiro","family":"Higashihara","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Okayama University Hospital 2\u20105\u20101 Shikatacho, Kitaku 700\u20108558 Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masanori","family":"Tamura","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Okayama University Hospital 2\u20105\u20101 Shikatacho, Kitaku 700\u20108558 Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ximing","family":"Zhang","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Okayama University Hospital 2\u20105\u20101 Shikatacho, Kitaku 700\u20108558 Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haowei","family":"Xue","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Okayama University Hospital 2\u20105\u20101 Shikatacho, Kitaku 700\u20108558 Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshifumi","family":"Ozaki","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Okayama University Hospital 2\u20105\u20101 Shikatacho, Kitaku 700\u20108558 Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,5,4]]},"reference":[{"key":"e_1_2_11_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2012.10.026"},{"key":"e_1_2_11_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13018\u2010014\u20100065\u20108"},{"key":"e_1_2_11_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010011\u20101794\u20104"},{"key":"e_1_2_11_5_2","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.183.1.1830017"},{"key":"e_1_2_11_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010020\u201006363\u20100"},{"key":"e_1_2_11_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010013\u20102656\u2010z"},{"key":"e_1_2_11_8_2","doi-asserted-by":"publisher","DOI":"10.1115\/1.4027468"},{"key":"e_1_2_11_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jos.2017.03.013"},{"key":"e_1_2_11_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2017.07.022"},{"key":"e_1_2_11_11_2","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.04.1024"},{"key":"e_1_2_11_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2020.12.020"},{"key":"e_1_2_11_13_2","doi-asserted-by":"crossref","unstructured":"KaplanDJ BloomD AlaiaEF WalterWR MeislinRJ StraussEJet al. 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