The multi-site volume of the meniscus in nuclear magnetic resonance images of children demonstrates an age-related increase.

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Dawei Qu, Kan Wang, Huadong Zhang, Zhongli Zhang This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7569349/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Backgrond: The meniscus plays a pivotal role in knee joint function, and it is widely recognized that precise trimming or suturing of the meniscus yields superior outcomes. However, treatment standards for pediatric meniscal injuries cannot be directly extrapolated to adults. This study utilized magnetic resonance imaging data to assess the width and height of the meniscus at multiple sites in children across different age groups, aiming to investigate age-related growth and development patterns of the meniscus and contribute to promote treatment guidelines for pediatric patients. Data and METHODS: Retrospective collection of magnetic resonance imaging data from pediatric patients treated at our hospital between 2015 and 2023 was conducted. Exclusion criteria encompassed meniscal injuries, deformities, as well as synovial accumulation related to knee joint diseases that do not represent normal meniscal status. Measurements were taken for the width and height of both medial and lateral menisci at multiple sites, followed by statistical analysis correlating these measurements with age. Results: Meniscal volume demonstrated a significant increase with age (P < 0.01). Sites showing statistically significant volume increases were observed in 75% of cases aged 3–11 years old; conversely, no statistically significant volume increases were found in 91.7% of cases aged 12–17 years old. When comparing symmetry between medial and lateral menisci sites, it was noted that lateral menisci exhibited significantly higher measurement values (P < 0.01), albeit with a small mean difference. Conclusions: As individuals matured, there was a trend towards centralized transition from immature to mature volumes across different sites within the meniscus; this growth tends to stabilize around 11–12 years old before approaching an adult-like shape at 15–17 years old. Prior to this stage, the volume falls below adult standards. While there was a statistical difference when comparing volumes between corresponding inner and outer sites on each side of the knee joint's central axis, this disparity was not deemed clinically significant. Meniscus MRI Pediatric Sport Medicine Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Introduction The meniscus serves as a critical stabilizing structure within the knee joint, facilitating essential functions such as flexion and extension rotation. It is responsible for load-bearing, shock absorption, joint lubrication, and fluid circulation [ 1 ]. Meniscal damage significantly impacts overall knee joint function. With a growing number of adolescents engaging in sports activities, there has been an uptick in meniscal tears among children [ 2 ]. Children exhibit a notably higher incidence of avulsion fracture of the tibial intercondylar spine compared to adults. This type of fracture often accompanies meniscal tears and anterior cruciate ligament rupture [ 3 ][ 4 ]. Additionally, discoid meniscus prevalence is more pronounced in Asia. It typically appears thicker and covers a larger area on the tibial plateau than normal menisci [ 5 ], making it more susceptible to injury and causing pain due to reduced stability maintenance. Early treatment methods involved complete or partial excision; however, this led to reports of knee instability and adverse complications such as early-onset osteoarthritis [ 6 ]. More recently, there has been an increased focus on meniscus repair with positive outcomes observed in related studies. Pediatric orthopedic surgeons have also reported successful outcomes from meniscus repair procedures performed on children [ 7 ]. This study aims to analyze nuclear magnetic resonance images (MRI) from numerous cases using indicators closely related to clinical practice. By identifying patterns in meniscal morphology at different sites with age, pediatric orthopedic doctors can gain better insights into normal meniscal morphology for improved treatment approaches. Materials and Methods This retrospective study was approved by our hospital's Ethics Committee. We collected knee MRI from adolescents and children between 2015–2023 who met specific criteria: showing normal meniscal shape under the age of 17 years old. A total of 697 cases were initially considered; however after applying exclusion criteria (such as previous injuries or surgical history), 466 eligible patients were included for analysis. The MRI images covered ages ranging from 3 years old to 17 years old (3-17.9), including 269 males and 197 females with both left and right knees represented .(Table 1 . General demographic information),( Fig. 1 Statistics of cases by age) Table 1 General demographic information Age 3–17 years (mean 9.37 years, SD 3.924) proportion total cases Male 269 cases 57.72% 466 Female 197 cases 42.27% Left 213 cases 45.71% Rigth 253 cases 54.29% The nuclear magnetic images were measured by three pediatric orthopedic doctors in our department. The measurement indexes included the following: 1. Medial meniscus anterior horn width (medial anterior width )(MAW) 2. Medial meniscus anterior horn height (medial anterior height)(MAH) 3. Medial meniscus posterior horn width (medial posterior width)(MPW) 4. Medial meniscus posterior horn height (medial posterior height)(MPH) 5. Medial meniscus body width (medial body width)(MBW) 6. Medial meniscus body height (medial body height)(MBH) 7. Lateral meniscus anterior horn width (lateral anterior width)(LAW) 8. Lateral meniscus anterior horn height (lateral anterior height)(LAH) 9. Lateral meniscus posterior foot width (lateral posterior width)(LPW) 10.Lateral meniscus posterior horn height(lateral posterior Height)(LWH) 11.Lateral meniscus body width(lateral Body Width)(LBW) 12.Lateral meniscus body height(lateral Body Height)(LBH) For the measurement of bilateral anterior and posterior horn, the section with the longest diameter of the femoral condyle on the sagittal plane was selected; for measurement of the body, the section with the smallest width of the meniscus section on the coronal plane was chosen [ 9 ][ 12 ] [ 13 ]. (Fig. 2 Measurement of meniscus upper surface width and height on sagittal plane and coronal plane.),( Fig. 3 Select the section of the longest axis of the medial and lateral femoral condyle on the sagittal plane and the section with the smallest meniscus width on the coronal plane.) Nuclear magnetic parameter: The nuclear magnetic equipment of our hospital was purchased from GE's Discovery MR750 3.0T. The patient was supine in neutral knee position with 15 knees bent. T1-weighted imaging (T1WI) and T2-weighted imaging (T2WI) images were obtained. 3-mm-thick slice with a 0.3-0.5mm gap between slices. Imaging was performed in the PACS system of our hospital, and the data were directly obtained by using the distance measurement mode in the image mode of PACS software. Data analysis In this study, three pediatric orthopedic physicians in our department independently conducted measurements on the same cases and obtained data using SPSS software and ICC random double-blind testing. The absolute consistency test at a significance level of P ≤ 0.01 yielded values which meet the criteria for consistency. The collected data was statistically analyzed using SPSS software to calculate the mean and age group ranges. Pearson coefficients were used to analyze the relationship between meniscus volume and age, while paired T-tests were employed to evaluate internal and lateral meniscus self-alignment as well as cross-alignment. The potential inflection points in the trend analysis were assessed using box plots of the measured volumes, and then age was grouped, and independent sample T-test was performed for each component Results A total of 466 cases were included in the study, with ages ranging from 3 to 17 years and an average age of 9.37 years. Of these, 269 were male and 197 were female. Due to blurred or missing MRI images, data for all 12 sites could not be obtained in some cases. The collected data are summarized in the table. (Table 2 Table 2 . Statistics of the number of measurement cases at each site) Table 2 Statistics of the number of measurement cases at each site site cases proportion MAW 450 96.57% MAH 450 96.57% MPW 455 97.64% MPH 455 97.64% MBW 456 97.85% MBH 456 97.85% LAW 434 93.13% LAH 434 93.13% LPW 434 93.13% LPH 434 93.13% LBW 432 92.70% LBH 432 92.70% In general, there was a positive correlation between the volume of the inner and outer meniscus and age. The correlation coefficients for the LPW (r = 0.682, p < 0.01), LAW (r = 0.623, p < 0.01), LBH (r = 0.612, p < 0.01), and MBH (r = 0.634, p < 0.01) were higher. However, the correlation coefficients for the MAH (r = 0.360, p < 0.01), MPH (r = 0.386,p < 0 .01), and LBW ( r = 0222 ,p < 001 ) were lower.(Table 3 Correlation statistics of each site volume and age) Table 3 Correlation statistics of each site volume and age age MAW MAH MPW MPH MBW MBH LAW LAH LPW LPH LBW LBH age Pearson correlation 1 .456 ** .365 ** .566 ** .401 ** .498 ** .638 ** .629 ** .283 ** .669 ** .433 ** .219 ** .620 ** Significance (double tail) .000 .000 .000 .000 .000 .000 .000 .000 .000 .000 .000 .000 Number of cases 466 450 450 455 455 456 456 434 434 434 434 432 432 In terms of differences, the posterior horn of the medial meniscus exhibited significantly greater width (p < 0.01) and height (p < 0.01) compared to the anterior horn. Conversely, while there was no statistical difference in width for the posterior horn of the lateral meniscus, it did exhibit a significantly higher height than the anterior horn (p < 0.01). When comparing medial and lateral meniscus, it was found that the anterior horn of the lateral meniscus was wider and higher (p < 0.01), while the posterior horn of the lateral meniscus had a significantly greater height (p < 0.01). Additionally, it was observed that the posterior horn of medial meniscus had a wider width (p < 0.01), whereas both height and width were greater in body for lateral menisci compared to medial ones (p < 0.01).(Table 4 Comparison and contrast between medial and lateral meniscus) Table 4. Comparison and contrast between medial and lateral meniscus Pairing difference t Degree of freedom Significance (double tail) Mean standard Standard deviation Mean standard error Difference 95% confidence interval Lower limit Upper limit Pairing 1 MAW - MPW -2.60153 2.29810 .10833 -2.81444 -2.38863 -24.014 449 .000 Pairing 2 MAH - MPH -1.48716 1.30075 .06132 -1.60766 -1.36665 -24.253 449 .000 Pairing 3 LAW - LPW -.09929 1.61632 .07759 -.25178 .05321 -1.280 433 .201 Pairing 4 LAH - LPH -1.30415 1.13398 .05443 -1.41113 -1.19716 -23.959 433 .000 Pairing 5 MBW - LBW -1.47986 1.99067 .09645 -1.66943 -1.29028 -15.344 425 .000 Pairing 6 MBH - LBH -.93477 1.04083 .05043 -1.03389 -.83565 -18.536 425 .000 Pairing 7 MAW - LAW -2.18969 2.04292 .09968 -2.38563 -1.99375 -21.966 419 .000 Pairing 8 MAH - LAH -.45945 1.25657 .06131 -.57997 -.33893 -7.493 419 .000 Pairing 9 MPW - LPW .31838 1.94590 .09439 .13285 .50391 3.373 424 .001 Pairing 10 MPH - WPH -.24224 1.20869 .05863 -.35748 -.12699 -4.132 424 .000 The trend analysis of the measurements at each site reveals a gradual increase in growth rate with age. The inflection point of the growth rate is observed at the age of 11–12 years through box diagram analysis, and The prominent changes in volume are primarily seen in outer body height and outer back width (Fig. 4 Volume trend chart of each site). It is evident that there exists a linear correlation between the MAW, MPW, MBH, LAW, LPW, and LBH. However, upon comprehensive observation of all site parameters, it becomes apparent that the linear slope undergoes a change in the latter half. In order to assess this changing pattern and integrate all parameters, we categorized the age groups and observed the mass change pattern of the sites as age increased, by examining the statistical differences between the groups. Specifically, group 1 consists of children aged 2–5 years old; group 2 consists of children aged 6–8 years old; group 3 consists of children aged 9–11 years old; group 4 consists of children aged 12–14 years old; and finally, group 5 consists of children aged 15–17 years old. Differences were tested by age group (Group 1- Group 2, group 2- group 3, group 3- group 4, group 4- group 5). (Fig. 5T-test between age groups,The half-rectangle diagram indicates a statistically significant relationship between the two groups.) Specially, in the analysis of 12 parameters, mode 1 accounted for 50%, mode 2 accounted for 25%, and their combined effect accounted for 75%. (Table 5 Trend for each site,⚪ means statistical difference, ×means no statistical difference.)The proportion of groups 1 to 2 and 2 to 3 with statistical difference was 75%, and the proportion of groups 4 to 5 with no statistical difference was 91.7%(Fig. 7 Groups 1-group 2 and group 2-group 3 has statistic difference accounts for 75% for all parameters. Group 4-group 5 has no statistic difference accounts for 91.5% for all parameters) Table 5 Trend for each site,⚪ means statistical difference,×means no statistical difference. Statistical difference group 1-group2 group 2-group3 group 3-group4 group 4-group5 proportion MAW ⚪ ⚪ × × mode 1 50% MAH ⚪ ⚪ × × mode 1 MPW ⚪ ⚪ × × mode 1 MPH ⚪ ⚪ × × mode 1 MBW ⚪ ⚪ × × mode 1 MBH ⚪ ⚪ × × mode 1 LAW ⚪ ⚪ ⚪ × mode 2 25% LAH ⚪ ⚪ ⚪ × mode 2 LPW ⚪ ⚪ ⚪ × mode 2 LPH × × ⚪ × 8.3% LBW × × ⚪ ⚪ 8.3% LBH ⚪ × × × 8.3% Discussion In our center, discoid meniscus is the most prevalent condition in pediatric orthopedic arthroscopic surgery. The most common symptoms include pain, snapping, and limited flexion and extension [ 14 ]. Discoid meniscus is prone to tearing, and surgical intervention is typically recommended for symptomatic cases [ 8 ]. The incidence of meniscal tears is higher in children, and the width of the preserved meniscus should be taken into consideration when repairing and reshaping the torn meniscus. For children with high mobility requirements, meniscus transplantation is recommended to alleviate pain [ 15 ]. Therefore, it is crucial for pediatric orthopedic sports medicine physicians to assess meniscal width and understand the morphological development process of the meniscus in children of different ages. The most significant discovery of this study is our speculation that the age range of 11–12 years old may represent a transitional period for meniscus growth and development. In Bedoya et al.'s report [ 9 ], it was noted that multi-site meniscus volume increased with age, but they did not propose a specific transitional stage to maturity. Similarly, Rohde et al. [ 10 ] concluded that meniscus growth occurred with age based on specimen studies (with a maximum age of 12 years old), but they also did not provide an explanation for the transitional stage of meniscus development. In our study, we observed changes in meniscus parameters at each site over time using box diagrams. In most cases, it appeared that the growth rate of the meniscus changed in the latter part of the age group. Based on this observation, we grouped the data by age and evaluated changes by comparing differences among different age groups for parameters at the same site. Overall, we found that among the 12 parameters, 91.7% of them had no change at 12–14 years old and 15–17 years old, and 75% of them increased with age at 2–11 years old, showing statistical significance. Therefore, we speculated that meniscus of children younger than 11 years old increased with age, and the meniscus growth and development period was from 11 to 12 years old. There was no significant change in meniscus volume in children older than 12 years. In the study by Takeda et al. [ 16 ], the high signal performance on the nuclear magnetic images in children indicated their blood flow situation. Observing changes in the proportion of high signal blood flow in the menisci of children and adults, it was suggested that the blood flow pattern after 10 yeas closely resembled that of adults, which consistent with our findings. Lin et al. [ 17 ] and other research reports [ 18 ][ 19 ] also noted that blood flow in children's meniscus initially favored the middle part and gradually shifted towards the marginal 1/3 region with age, providing insight into growth patterns observed in our study. We also observed that in the 15–17 years old period, the width of each volume was close to the index of 8-10mm in the literature [ 20 ], while before this age, the width of each volume was less than 8mm. In our study, the width of the posterior horn of the medial meniscus is larger than the counterpart of lateral meniscus, however, the residual parameters of the lateral meniscus are larger than those of the medial meniscus. Al thought the mean difference in the anterior horn width is approximately 2mm, and the body width difference is about 1.4mm, the mean difference for other indicators is less than 1mm. Campbell's Operative Orthopaedics (11th edition) describes the meniscus as having "a larger diameter of the medial meniscus than the lateral meniscus", which may be due to differences in measurement methods compared to our study. Previous literature [ 9 ][ 13 ][ 21 ] measured meniscal shape using MRI, with width being defined as distance between vertex of transverse triangle section and edge. In our study, we chose to measure meniscal upper surface as the width because this area is visible during surgery, rather than measuring height of transverse triangle. TThis may hold particularly true for pediatric orthopedic surgeons.. Bedoya et al [ 9 ] literature reviews collected data from 186 cases aged between 0.3 and 17 years old, observing an increase in multi-site volume with age but no clear trend - possibly the difference is due to sample size limitations or different measurement methods for meniscal width. Rohde et al.'s study [ 10 ] on anatomical specimens under age 12 found increasing volume with age; while specimen measurements offer greater accuracy they may be limited by upper age range and sample size making it difficult to observe transitional periods clearly. Reports comparing medial and lateral menisci show differing volumes for medial multi-site[ 9 ], consistent with findings in our own reports; although statistically significant differences exist, mean volume differences are small. A larger sample size would be needed to draw definitive conclusions regarding such small discrepancies.In practical terms, considering the precision of the procedure, it appears justifiable to utilize the opposite meniscus as the point of reference when preserving the meniscus edge. There are limitations in this study as well. MRI measurement is unable to capture the natural dynamics of the human body. While NMR measurement of meniscus morphology is currently a common and reliable method, its performance under arthroscopy may be slightly different. The study does not observe the same growth trends for all sites parameters, and it remains uncertain whether this is due to sample size or measurement method, or if the growth trend of parameters at each site is inherent. Although our study obtained the mean volume of meniscus at each site at each age, further observational studies are necessary to validate whether this represents the standard for achieving favorable surgical outcomes. Conclusion: Based on nuclear magnetic imaging observations, meniscus size increases with age, reaching a transitional period from immature to mature around 11–12 years old. Subsequently, meniscus growth stabilizes and approaches adult size by 15–17 years old. Before maturity, the volume of each site on the meniscus falls below adult standards, which has implications for pediatric orthopedic surgical treatment. Declarations Author Contribution 1.Dawei Qu Proposed ideas, collected materials, participated in measurement, performed statistical calculations,prepared figures and tables and write article.2.Kan WANG Participated in measurement, performed statistical calculations,perpared Figures and Tables3.Huadong Zhang Participated in measurement4.Zhongli Zhang Designed the overall research scheme, monitored and evaluated the rigor of research materials, participated in result analysis, reviewed the manuscript, and conducted communication on academic background. References Colette VE, Pieter C, Hilde V et al (2020) Can a ratio between medial and lateral meniscal volumes be calculated to determine critical meniscal volume in view of post-meniscectomy symptoms [. 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J Bone Joint Surg Br 80(3):463–467 Lin KM, Gadinsky NE, Klinger CE, Dyke JP, Rodeo SA, Green DW, Fabricant PD, Helfet DL, Shea KG, Lazaro LE (2021) Increased Vascularity in the Neonatal versus Adult Meniscus: Evaluation with Magnetic Resonance Imaging. Cartilage 13(2suppl):1562S–1569S Arnoczky SP, Warren RF (1982 Mar-Apr) Microvasculature of the human meniscus. Am J Sports Med 10(2):90–95 Petersen W, Tillmann B (1995) Age-related blood and lymph supply of the knee menisci. A cadaver study. Acta Orthop Scand 66(4):308–312 Hashimoto Y, Yamasaki S, Reid JB 3rd, Guttmann D, Nishino K, Nakamura H (2021) Arthroscopic Saucerization With Inside-Out Repair and Anterocentral Shift of a Discoid Lateral Meniscus With Retention of Adequate Volume of Residual Meniscus. Arthrosc Tech 10(11):e2553–e2557 Matsuo T, Kinugasa K, Sakata K, Ohori T, Mae T, Hamada M (2017) Post-operative deformation and extrusion of the discoid lateral meniscus following a partial meniscectomy with repair. Knee Surg Sports Traumatol Arthrosc 25(2):390–396 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7569349","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":513648689,"identity":"7e4361b4-ab24-4424-ac9b-5740732498ef","order_by":0,"name":"Dawei Qu","email":"","orcid":"","institution":"Tianjin University Tianjin Hospotal","correspondingAuthor":false,"prefix":"","firstName":"Dawei","middleName":"","lastName":"Qu","suffix":""},{"id":513648690,"identity":"f94acb70-a434-4dd5-ae7e-e421c4c437df","order_by":1,"name":"Kan Wang","email":"","orcid":"","institution":"Tianjin University Tianjin 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1","display":"","copyAsset":false,"role":"figure","size":50708,"visible":true,"origin":"","legend":"\u003cp\u003eStatistics of cases by age\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-7569349/v1/cb249b1ebe6fc3d9e92d55bf.png"},{"id":91837716,"identity":"5e1a1860-1740-4942-be93-a20fea914e7e","added_by":"auto","created_at":"2025-09-22 09:41:29","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":221336,"visible":true,"origin":"","legend":"\u003cp\u003eMeasurement of meniscus upper surface width and height on sagittal plane and coronal plane\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-7569349/v1/2cbd57c5065cbe3293251df9.png"},{"id":91843272,"identity":"10c1e351-f174-46de-aa13-c3f2fbf9ab6c","added_by":"auto","created_at":"2025-09-22 10:05:29","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":171874,"visible":true,"origin":"","legend":"\u003cp\u003eSelect the section of the longest axis of the medial and lateral femoral condyle on the sagittal plane and the section with the smallest meniscus width on the coronal plane\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-7569349/v1/7dac9b0ac491fe93bc4157cb.png"},{"id":91837715,"identity":"8e22ed25-f459-4a63-9fec-6e493e71aac8","added_by":"auto","created_at":"2025-09-22 09:41:29","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":228256,"visible":true,"origin":"","legend":"\u003cp\u003eVolume trend chart of each site\u003c/p\u003e","description":"","filename":"4.png","url":"https://assets-eu.researchsquare.com/files/rs-7569349/v1/235a971fd5532fde0866f666.png"},{"id":91837718,"identity":"d795ee7c-8927-47d1-ab36-574526197fb3","added_by":"auto","created_at":"2025-09-22 09:41:29","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":235138,"visible":true,"origin":"","legend":"\u003cp\u003eT-test between age groups,The half-rectangle diagram indicates a statistically significant relationship between the two groups\u003c/p\u003e","description":"","filename":"5.png","url":"https://assets-eu.researchsquare.com/files/rs-7569349/v1/f6eca4afd759c75e11ea8898.png"},{"id":91835807,"identity":"94e62fa9-0a31-4009-8b2b-8e658c49da2c","added_by":"auto","created_at":"2025-09-22 09:33:29","extension":"png","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":21685,"visible":true,"origin":"","legend":"\u003cp\u003eMode proportion\u003c/p\u003e","description":"","filename":"6.png","url":"https://assets-eu.researchsquare.com/files/rs-7569349/v1/a96eb950312db12043e326c3.png"},{"id":91838731,"identity":"ffcf9d39-6f6c-470e-b5ce-0817fabb871a","added_by":"auto","created_at":"2025-09-22 09:49:29","extension":"png","order_by":7,"title":"Figure 7","display":"","copyAsset":false,"role":"figure","size":44210,"visible":true,"origin":"","legend":"\u003cp\u003eGroups 1-group 2 and group 2-group 3 has statistic difference accounts for 75% for all parameters. Group 4-group 5 has no statistic difference accounts for 91.5% for all parameters\u003c/p\u003e","description":"","filename":"7.png","url":"https://assets-eu.researchsquare.com/files/rs-7569349/v1/36508b855e5808d90f3ac23c.png"},{"id":95013495,"identity":"fbba6610-6af5-401e-9574-b472532ee0c3","added_by":"auto","created_at":"2025-11-03 10:39:05","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1687110,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7569349/v1/d665b329-d8bc-4614-a895-ad1d68cdac31.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"The multi-site volume of the meniscus in nuclear magnetic resonance images of children demonstrates an age-related increase.","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThe meniscus serves as a critical stabilizing structure within the knee joint, facilitating essential functions such as flexion and extension rotation. It is responsible for load-bearing, shock absorption, joint lubrication, and fluid circulation [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Meniscal damage significantly impacts overall knee joint function.\u003c/p\u003e\u003cp\u003eWith a growing number of adolescents engaging in sports activities, there has been an uptick in meniscal tears among children [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Children exhibit a notably higher incidence of avulsion fracture of the tibial intercondylar spine compared to adults. This type of fracture often accompanies meniscal tears and anterior cruciate ligament rupture [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e][\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Additionally, discoid meniscus prevalence is more pronounced in Asia. It typically appears thicker and covers a larger area on the tibial plateau than normal menisci [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e], making it more susceptible to injury and causing pain due to reduced stability maintenance.\u003c/p\u003e\u003cp\u003eEarly treatment methods involved complete or partial excision; however, this led to reports of knee instability and adverse complications such as early-onset osteoarthritis [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. More recently, there has been an increased focus on meniscus repair with positive outcomes observed in related studies. Pediatric orthopedic surgeons have also reported successful outcomes from meniscus repair procedures performed on children [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThis study aims to analyze nuclear magnetic resonance images (MRI) from numerous cases using indicators closely related to clinical practice. By identifying patterns in meniscal morphology at different sites with age, pediatric orthopedic doctors can gain better insights into normal meniscal morphology for improved treatment approaches.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cp\u003eThis retrospective study was approved by our hospital\u0026apos;s Ethics Committee. We collected knee MRI from adolescents and children between 2015\u0026ndash;2023 who met specific criteria: showing normal meniscal shape under the age of 17 years old. A total of 697 cases were initially considered; however after applying exclusion criteria (such as previous injuries or surgical history), 466 eligible patients were included for analysis. The MRI images covered ages ranging from 3 years old to 17 years old (3-17.9), including 269 males and 197 females with both left and right knees represented .(Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e. General demographic information),( Fig. 1 Statistics of cases by age)\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n \u003ctable id=\"Tab1\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eGeneral demographic information\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e3\u0026ndash;17 years (mean 9.37 years, SD 3.924)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eproportion\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003etotal cases\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e269 cases\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e57.72%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" rowspan=\"4\"\u003e\n \u003cp\u003e466\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e197 cases\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e42.27%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLeft\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e213 cases\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e45.71%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRigth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e253 cases\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e54.29%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eThe nuclear magnetic images were measured by three pediatric orthopedic doctors in our department. The measurement indexes included the following:\u003c/p\u003e\n\u003cp\u003e\u003cspan\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003e1. Medial meniscus anterior horn width (medial anterior width )(MAW)\u003c/p\u003e\u003cspan\u003e\n \u003cp\u003e2. Medial meniscus anterior horn height (medial anterior height)(MAH)\u003c/p\u003e\n\u003c/span\u003e\u003cspan\u003e\n \u003cp\u003e3. Medial meniscus posterior horn width (medial posterior width)(MPW)\u003c/p\u003e\n\u003c/span\u003e\u003cspan\u003e\n \u003cp\u003e4. Medial meniscus posterior horn height (medial posterior height)(MPH)\u003c/p\u003e\n\u003c/span\u003e\u003cspan\u003e\n \u003cp\u003e5. Medial meniscus body width (medial body width)(MBW)\u003c/p\u003e\n\u003c/span\u003e\u003cspan\u003e\n \u003cp\u003e6. Medial meniscus body height (medial body height)(MBH)\u003c/p\u003e\n\u003c/span\u003e\u003cspan\u003e\n \u003cp\u003e7. Lateral meniscus anterior horn width (lateral anterior width)(LAW)\u003c/p\u003e\n\u003c/span\u003e\u003cspan\u003e\n \u003cp\u003e8. Lateral meniscus anterior horn height (lateral anterior height)(LAH)\u003c/p\u003e\n\u003c/span\u003e\u003cspan\u003e\n \u003cp\u003e9. Lateral meniscus posterior foot width (lateral posterior width)(LPW)\u003c/p\u003e\n\u003c/span\u003e\u003cspan\u003e\n \u003cp\u003e10.Lateral meniscus posterior horn height(lateral posterior Height)(LWH)\u003c/p\u003e\n\u003c/span\u003e\u003cspan\u003e\n \u003cp\u003e11.Lateral meniscus body width(lateral Body Width)(LBW)\u003c/p\u003e\n\u003c/span\u003e\u003cspan\u003e\n \u003cp\u003e12.Lateral meniscus body height(lateral Body Height)(LBH)\u003c/p\u003e\n\u003c/span\u003e\n\u003cp\u003e\u003c/p\u003e\n\u003cp\u003eFor the measurement of bilateral anterior and posterior horn, the section with the longest diameter of the femoral condyle on the sagittal plane was selected; for measurement of the body, the section with the smallest width of the meniscus section on the coronal plane was chosen [\u003cspan class=\"CitationRef\"\u003e9\u003c/span\u003e][\u003cspan class=\"CitationRef\"\u003e12\u003c/span\u003e] [\u003cspan class=\"CitationRef\"\u003e13\u003c/span\u003e]. (Fig.\u0026nbsp;2 Measurement of meniscus upper surface width and height on sagittal plane and coronal plane.),( Fig.\u0026nbsp;3 Select the section of the longest axis of the medial and lateral femoral condyle on the sagittal plane and the section with the smallest meniscus width on the coronal plane.)\u003c/p\u003e\n\u003cp\u003eNuclear magnetic parameter:\u003c/p\u003e\n\u003cp\u003eThe nuclear magnetic equipment of our hospital was purchased from GE\u0026apos;s Discovery MR750 3.0T. The patient was supine in neutral knee position with 15 knees bent. T1-weighted imaging (T1WI) and T2-weighted imaging (T2WI) images were obtained. 3-mm-thick slice with a 0.3-0.5mm gap between slices. Imaging was performed in the PACS system of our hospital, and the data were directly obtained by using the distance measurement mode in the image mode of PACS software.\u003c/p\u003e\n\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\n \u003ch2\u003eData analysis\u003c/h2\u003e\n \u003cp\u003eIn this study, three pediatric orthopedic physicians in our department independently conducted measurements on the same cases and obtained data using SPSS software and ICC random double-blind testing. The absolute consistency test at a significance level of P\u0026thinsp;\u0026le;\u0026thinsp;0.01 yielded values which meet the criteria for consistency.\u003c/p\u003e\n \u003cp\u003eThe collected data was statistically analyzed using SPSS software to calculate the mean and age group ranges. Pearson coefficients were used to analyze the relationship between meniscus volume and age, while paired T-tests were employed to evaluate internal and lateral meniscus self-alignment as well as cross-alignment. The potential inflection points in the trend analysis were assessed using box plots of the measured volumes, and then age was grouped, and independent sample T-test was performed for each component\u003c/p\u003e\n\u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eA total of 466 cases were included in the study, with ages ranging from 3 to 17 years and an average age of 9.37 years. Of these, 269 were male and 197 were female. Due to blurred or missing MRI images, data for all 12 sites could not be obtained in some cases. The collected data are summarized in the table. (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e. Statistics of the number of measurement cases at each site)\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eStatistics of the number of measurement cases at each site\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003esite\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003ecases\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eproportion\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMAW\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e450\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e96.57%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMAH\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e450\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e96.57%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMPW\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e455\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e97.64%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMPH\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e455\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e97.64%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMBW\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e456\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e97.85%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMBH\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e456\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e97.85%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLAW\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e434\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e93.13%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLAH\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e434\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e93.13%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLPW\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e434\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e93.13%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLPH\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e434\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e93.13%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLBW\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e432\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e92.70%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLBH\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e432\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e92.70%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eIn general, there was a positive correlation between the volume of the inner and outer meniscus and age. The correlation coefficients for the LPW (r\u0026thinsp;=\u0026thinsp;0.682, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01), LAW (r\u0026thinsp;=\u0026thinsp;0.623, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01), LBH (r\u0026thinsp;=\u0026thinsp;0.612, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01), and MBH (r\u0026thinsp;=\u0026thinsp;0.634, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01) were higher. However, the correlation coefficients for the MAH (r\u0026thinsp;=\u0026thinsp;0.360, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01), MPH (r\u0026thinsp;=\u0026thinsp;0.386,p\u0026thinsp;\u0026lt;\u0026thinsp;0 .01), and LBW ( r\u0026thinsp;=\u0026thinsp;0222 ,p\u0026thinsp;\u0026lt;\u0026thinsp;001 ) were lower.(Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e Correlation statistics of each site volume and age)\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eCorrelation statistics of each site volume and age\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"15\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c13\" colnum=\"13\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c14\" colnum=\"14\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c15\" colnum=\"15\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eage\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eMAW\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eMAH\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eMPW\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eMPH\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003eMBW\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u003cp\u003eMBH\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c10\"\u003e\u003cp\u003eLAW\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c11\"\u003e\u003cp\u003eLAH\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c12\"\u003e\u003cp\u003eLPW\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c13\"\u003e\u003cp\u003eLPH\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c14\"\u003e\u003cp\u003eLBW\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c15\"\u003e\u003cp\u003eLBH\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eage\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePearson correlation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.456\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e.365\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.566\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.401\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e.498\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e.638\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e.629\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e.283\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e.669\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e.433\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003e.219\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e.620\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSignificance (double tail)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003e.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNumber of cases\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e466\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e450\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e450\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e455\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e455\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e456\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e456\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e434\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e434\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e434\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e434\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003e432\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e432\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cbr\u003e\u003cp\u003eIn terms of differences, the posterior horn of the medial meniscus exhibited significantly greater width (p\u0026thinsp;\u0026lt;\u0026thinsp;0.01) and height (p\u0026thinsp;\u0026lt;\u0026thinsp;0.01) compared to the anterior horn. Conversely, while there was no statistical difference in width for the posterior horn of the lateral meniscus, it did exhibit a significantly higher height than the anterior horn (p\u0026thinsp;\u0026lt;\u0026thinsp;0.01). When comparing medial and lateral meniscus, it was found that the anterior horn of the lateral meniscus was wider and higher (p\u0026thinsp;\u0026lt;\u0026thinsp;0.01), while the posterior horn of the lateral meniscus had a significantly greater height (p\u0026thinsp;\u0026lt;\u0026thinsp;0.01). Additionally, it was observed that the posterior horn of medial meniscus had a wider width (p\u0026thinsp;\u0026lt;\u0026thinsp;0.01), whereas both height and width were greater in body for lateral menisci compared to medial ones (p\u0026thinsp;\u0026lt;\u0026thinsp;0.01).(Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e Comparison and contrast between medial and lateral meniscus)\u003c/p\u003e\u003cp\u003eTable 4. Comparison and contrast between medial and lateral meniscus\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"557\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"10\" style=\"width: 821px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" rowspan=\"3\" valign=\"bottom\" style=\"width: 174px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"5\" valign=\"bottom\" style=\"width: 398px;\"\u003e\n \u003cp\u003ePairing difference\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"bottom\" style=\"width: 73px;\"\u003e\n \u003cp\u003et\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"bottom\" style=\"width: 73px;\"\u003e\n \u003cp\u003e\u0026nbsp;Degree of freedom\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"bottom\" style=\"width: 104px;\"\u003e\n \u003cp\u003eSignificance (double tail)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"bottom\" style=\"width: 74px;\"\u003e\n \u003cp\u003eMean standard\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"bottom\" style=\"width: 73px;\"\u003e\n \u003cp\u003eStandard \u0026nbsp;deviation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"bottom\" style=\"width: 104px;\"\u003e\n \u003cp\u003eMean standard error\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 147px;\"\u003e\n \u003cp\u003eDifference 95% confidence interval\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 74px;\"\u003e\n \u003cp\u003eLower limit\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 74px;\"\u003e\n \u003cp\u003eUpper limit\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003ePairing 1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003eMAW - MPW\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e-2.60153\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e2.29810\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e.10833\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e-2.81444\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e-2.38863\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e-24.014\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e449\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003ePairing 2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003eMAH - MPH\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e-1.48716\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e1.30075\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e.06132\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e-1.60766\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e-1.36665\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e-24.253\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e449\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003ePairing 3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003eLAW - LPW\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e-.09929\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e1.61632\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e.07759\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e-.25178\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e.05321\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e-1.280\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e433\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e.201\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003ePairing 4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003eLAH - LPH\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e-1.30415\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e1.13398\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e.05443\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e-1.41113\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e-1.19716\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e-23.959\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e433\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003ePairing 5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003eMBW - LBW\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e-1.47986\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e1.99067\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e.09645\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e-1.66943\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e-1.29028\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e-15.344\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e425\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003ePairing 6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003eMBH - LBH\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e-.93477\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e1.04083\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e.05043\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e-1.03389\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e-.83565\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e-18.536\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e425\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003ePairing 7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003eMAW - LAW\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e-2.18969\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e2.04292\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e.09968\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e-2.38563\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e-1.99375\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e-21.966\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e419\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003ePairing 8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003eMAH - LAH\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e-.45945\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e1.25657\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e.06131\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e-.57997\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e-.33893\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e-7.493\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e419\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003ePairing 9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003eMPW - LPW\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e.31838\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e1.94590\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e.09439\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e.13285\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e.50391\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e3.373\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e424\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003ePairing 10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003eMPH - WPH\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e-.24224\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e1.20869\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e.05863\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e-.35748\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e-.12699\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e-4.132\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e424\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\u003cbr\u003e\n\u003cp\u003eThe trend analysis of the measurements at each site reveals a gradual increase in growth rate with age. The inflection point of the growth rate is observed at the age of 11\u0026ndash;12 years through box diagram analysis, and The prominent changes in volume are primarily seen in outer body height and outer back width (Fig.\u0026nbsp;4 Volume trend chart of each site).\u003c/p\u003e\u003cp\u003eIt is evident that there exists a linear correlation between the MAW, MPW, MBH, LAW, LPW, and LBH. However, upon comprehensive observation of all site parameters, it becomes apparent that the linear slope undergoes a change in the latter half. In order to assess this changing pattern and integrate all parameters, we categorized the age groups and observed the mass change pattern of the sites as age increased, by examining the statistical differences between the groups. Specifically, group 1 consists of children aged 2\u0026ndash;5 years old; group 2 consists of children aged 6\u0026ndash;8 years old; group 3 consists of children aged 9\u0026ndash;11 years old; group 4 consists of children aged 12\u0026ndash;14 years old; and finally, group 5 consists of children aged 15\u0026ndash;17 years old. Differences were tested by age group (Group 1- Group 2, group 2- group 3, group 3- group 4, group 4- group 5). (Fig.\u0026nbsp;5T-test between age groups,The half-rectangle diagram indicates a statistically significant relationship between the two groups.)\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eSpecially, in the analysis of 12 parameters, mode 1 accounted for 50%, mode 2 accounted for 25%, and their combined effect accounted for 75%. (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e Trend for each site,⚪ means statistical difference, \u0026times;means no statistical difference.)The proportion of groups 1 to 2 and 2 to 3 with statistical difference was 75%, and the proportion of groups 4 to 5 with no statistical difference was 91.7%(Fig.\u0026nbsp;7 Groups 1-group 2 and group 2-group 3 has statistic difference accounts for 75% for all parameters. Group 4-group 5 has no statistic difference accounts for 91.5% for all parameters)\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eTrend for each site,⚪ means statistical difference,\u0026times;means no statistical difference.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"7\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eStatistical difference\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003egroup 1-group2\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003egroup 2-group3\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003egroup 3-group4\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003egroup 4-group5\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eproportion\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMAW\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e⚪\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e⚪\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026times;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026times;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003emode 1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"5\" rowspan=\"6\"\u003e\u003cp\u003e50%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMAH\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e⚪\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e⚪\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026times;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026times;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003emode 1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMPW\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e⚪\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e⚪\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026times;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026times;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003emode 1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMPH\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e⚪\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e⚪\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026times;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026times;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003emode 1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMBW\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e⚪\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e⚪\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026times;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026times;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003emode 1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMBH\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e⚪\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e⚪\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026times;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026times;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003emode 1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLAW\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e⚪\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e⚪\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e⚪\u003c/p\u003e\u003c/td\u003e\u003ctd 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align=\"left\" colname=\"c2\"\u003e\u003cp\u003e⚪\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e⚪\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e⚪\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026times;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003emode 2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLPH\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026times;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026times;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e⚪\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026times;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e8.3%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLBW\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026times;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026times;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e⚪\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e⚪\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e8.3%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLBH\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e⚪\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026times;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026times;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026times;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e8.3%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eIn our center, discoid meniscus is the most prevalent condition in pediatric orthopedic arthroscopic surgery. The most common symptoms include pain, snapping, and limited flexion and extension [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Discoid meniscus is prone to tearing, and surgical intervention is typically recommended for symptomatic cases [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. The incidence of meniscal tears is higher in children, and the width of the preserved meniscus should be taken into consideration when repairing and reshaping the torn meniscus. For children with high mobility requirements, meniscus transplantation is recommended to alleviate pain [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Therefore, it is crucial for pediatric orthopedic sports medicine physicians to assess meniscal width and understand the morphological development process of the meniscus in children of different ages.\u003c/p\u003e\u003cp\u003eThe most significant discovery of this study is our speculation that the age range of 11\u0026ndash;12 years old may represent a transitional period for meniscus growth and development. In Bedoya et al.'s report [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e], it was noted that multi-site meniscus volume increased with age, but they did not propose a specific transitional stage to maturity. Similarly, Rohde et al. [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e] concluded that meniscus growth occurred with age based on specimen studies (with a maximum age of 12 years old), but they also did not provide an explanation for the transitional stage of meniscus development. In our study, we observed changes in meniscus parameters at each site over time using box diagrams. In most cases, it appeared that the growth rate of the meniscus changed in the latter part of the age group. Based on this observation, we grouped the data by age and evaluated changes by comparing differences among different age groups for parameters at the same site.\u003c/p\u003e\u003cp\u003eOverall, we found that among the 12 parameters, 91.7% of them had no change at 12\u0026ndash;14 years old and 15\u0026ndash;17 years old, and 75% of them increased with age at 2\u0026ndash;11 years old, showing statistical significance. Therefore, we speculated that meniscus of children younger than 11 years old increased with age, and the meniscus growth and development period was from 11 to 12 years old. There was no significant change in meniscus volume in children older than 12 years.\u003c/p\u003e\u003cp\u003eIn the study by Takeda et al. [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e], the high signal performance on the nuclear magnetic images in children indicated their blood flow situation. Observing changes in the proportion of high signal blood flow in the menisci of children and adults, it was suggested that the blood flow pattern after 10 yeas closely resembled that of adults, which consistent with our findings. Lin et al. [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e] and other research reports [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e][\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e] also noted that blood flow in children's meniscus initially favored the middle part and gradually shifted towards the marginal 1/3 region with age, providing insight into growth patterns observed in our study.\u003c/p\u003e\u003cp\u003eWe also observed that in the 15\u0026ndash;17 years old period, the width of each volume was close to the index of 8-10mm in the literature [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e], while before this age, the width of each volume was less than 8mm.\u003c/p\u003e\u003cp\u003eIn our study, the width of the posterior horn of the medial meniscus is larger than the counterpart of lateral meniscus, however, the residual parameters of the lateral meniscus are larger than those of the medial meniscus. Al thought the mean difference in the anterior horn width is approximately 2mm, and the body width difference is about 1.4mm, the mean difference for other indicators is less than 1mm. Campbell's Operative Orthopaedics (11th edition) describes the meniscus as having \"a larger diameter of the medial meniscus than the lateral meniscus\", which may be due to differences in measurement methods compared to our study. Previous literature [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e][\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e][\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e] measured meniscal shape using MRI, with width being defined as distance between vertex of transverse triangle section and edge. In our study, we chose to measure meniscal upper surface as the width because this area is visible during surgery, rather than measuring height of transverse triangle. TThis may hold particularly true for pediatric orthopedic surgeons.. Bedoya et al [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e] literature reviews collected data from 186 cases aged between 0.3 and 17 years old, observing an increase in multi-site volume with age but no clear trend - possibly the difference is due to sample size limitations or different measurement methods for meniscal width. Rohde et al.'s study [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e] on anatomical specimens under age 12 found increasing volume with age; while specimen measurements offer greater accuracy they may be limited by upper age range and sample size making it difficult to observe transitional periods clearly. Reports comparing medial and lateral menisci show differing volumes for medial multi-site[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e], consistent with findings in our own reports; although statistically significant differences exist, mean volume differences are small. A larger sample size would be needed to draw definitive conclusions regarding such small discrepancies.In practical terms, considering the precision of the procedure, it appears justifiable to utilize the opposite meniscus as the point of reference when preserving the meniscus edge.\u003c/p\u003e\u003cp\u003eThere are limitations in this study as well. MRI measurement is unable to capture the natural dynamics of the human body. While NMR measurement of meniscus morphology is currently a common and reliable method, its performance under arthroscopy may be slightly different. The study does not observe the same growth trends for all sites parameters, and it remains uncertain whether this is due to sample size or measurement method, or if the growth trend of parameters at each site is inherent. Although our study obtained the mean volume of meniscus at each site at each age, further observational studies are necessary to validate whether this represents the standard for achieving favorable surgical outcomes.\u003c/p\u003e\u003cp\u003eConclusion: Based on nuclear magnetic imaging observations, meniscus size increases with age, reaching a transitional period from immature to mature around 11\u0026ndash;12 years old. Subsequently, meniscus growth stabilizes and approaches adult size by 15\u0026ndash;17 years old. Before maturity, the volume of each site on the meniscus falls below adult standards, which has implications for pediatric orthopedic surgical treatment.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003e1.Dawei Qu Proposed ideas, collected materials, participated in measurement, performed statistical calculations,prepared figures and tables and write article.2.Kan WANG Participated in measurement, performed statistical calculations,perpared Figures and Tables3.Huadong Zhang Participated in measurement4.Zhongli Zhang Designed the overall research scheme, monitored and evaluated the rigor of research materials, participated in result analysis, reviewed the manuscript, and conducted communication on academic background.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eColette VE, Pieter C, Hilde V et al (2020) Can a ratio between medial and lateral meniscal volumes be calculated to determine critical meniscal volume in view of post-meniscectomy symptoms [. J] Acta Orthop Belgica 86(1):77\u0026ndash;81\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eFrancavilla ML, Restrepo R, Zamora KW, Sarode V, Swirsky SM, Mintz D (2014) Meniscal pathology in children: differences and similarities with the adult meniscus. Pediatr Radiol 44(8):910\u0026ndash;925\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSeveryns M, Odri GA, Vendeuvre T, Marchand JB, Germaneau A, Dram\u0026eacute; M (2023) Meniscal injuries in skeletally immature children with tibial eminence fractures. Systematic review of literature. Int Orthop 47(10):2439\u0026ndash;2448\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eOshima T, Leie M, Grasso S, Parker DA (2019) Relationship between anterior cruciate ligament and anterolateral meniscal root bony attachment: High-resolution 3-T MRI analysis. Knee 26(3):537\u0026ndash;544\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKocher MS, Logan CA, Kramer DE (2017) Discoid Lateral Meniscus in Children: Diagnosis, Management, and Outcomes. J Am Acad Orthop Surg 25(11):736\u0026ndash;743\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eShi B, Stinson Z, Nault ML, Brey J, Beck J (2022) Meniscus Repair in Pediatric Athletes. Clin Sports Med 41(4):749\u0026ndash;767\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003ePetersen W, Karpinski K, Bierke S, M\u0026uuml;ller Rath R, H\u0026auml;ner M (2022) A systematic review about long-term results after meniscus repair. Arch Orthop Trauma Surg 142(5):835\u0026ndash;844\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHashimoto Y, Yamasaki S, Reid JB 3rd, Guttmann D, Nishino K, Nakamura H (2021) Arthroscopic Saucerization With Inside-Out Repair and Anterocentral Shift of a Discoid Lateral Meniscus With Retention of Adequate Volume of Residual Meniscus. Arthrosc Tech 10(11):e2553\u0026ndash;e2557\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBedoya MA, Barrera CA, Chauvin NA, Delgado J, Jaramillo D, Ho-Fung VM (2019) Normal meniscal dimensions at different patient ages-MRI evaluation. Skeletal Radiol 48(4):595\u0026ndash;603\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eRohde MS, Trivedi S, Randhawa S, Wright CE, Vuong BB, Pham N, Stavinoha T, Ellis HB, Ganley TJ, Green DW, Fabricant PD, Tompkins M, Shea KG (2023) Pediatric meniscus morphology varies with age: a cadaveric study. Knee Surg Sports Traumatol Arthrosc 31(10):4179\u0026ndash;4186\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eClark CR, Ogden JA (1983) Development of the menisci of the human knee joint. Morphological changes and their potential role in childhood meniscal injury. J Bone Joint Surg Am 65(4):538\u0026ndash;547\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMatsuo T, Kinugasa K, Sakata K, Ohori T, Mae T, Hamada M (2017) Post-operative deformation and extrusion of the discoid lateral meniscus following a partial meniscectomy with repair. Knee Surg Sports Traumatol Arthrosc 25(2):390\u0026ndash;396\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eYoon KH, Song SJ, Lee HS, Park CH (2020) Meniscal Injury Does Not Significantly Affect the Dimensions of the Intact Meniscus in the Opposite Compartment of the Knee. Orthop J Sports Med 8(2):2325967120904328\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eTapasvi S, Shekhar A, Eriksson K (2021) Discoid lateral meniscus: current concepts. J ISAKOS 6(1):14\u0026ndash;21\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eTuca M, Luderowski E, Rodeo S (2016) Meniscal transplant in children. Curr Opin Pediatr 28(1):47\u0026ndash;54\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eTakeda Y, Ikata T, Yoshida S, Takai H, Kashiwaguchi S (1998) MRI high-signal intensity in the menisci of asymptomatic children. J Bone Joint Surg Br 80(3):463\u0026ndash;467\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLin KM, Gadinsky NE, Klinger CE, Dyke JP, Rodeo SA, Green DW, Fabricant PD, Helfet DL, Shea KG, Lazaro LE (2021) Increased Vascularity in the Neonatal versus Adult Meniscus: Evaluation with Magnetic Resonance Imaging. Cartilage 13(2suppl):1562S\u0026ndash;1569S\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eArnoczky SP, Warren RF (1982 Mar-Apr) Microvasculature of the human meniscus. Am J Sports Med 10(2):90\u0026ndash;95\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003ePetersen W, Tillmann B (1995) Age-related blood and lymph supply of the knee menisci. A cadaver study. Acta Orthop Scand 66(4):308\u0026ndash;312\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHashimoto Y, Yamasaki S, Reid JB 3rd, Guttmann D, Nishino K, Nakamura H (2021) Arthroscopic Saucerization With Inside-Out Repair and Anterocentral Shift of a Discoid Lateral Meniscus With Retention of Adequate Volume of Residual Meniscus. Arthrosc Tech 10(11):e2553\u0026ndash;e2557\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMatsuo T, Kinugasa K, Sakata K, Ohori T, Mae T, Hamada M (2017) Post-operative deformation and extrusion of the discoid lateral meniscus following a partial meniscectomy with repair. Knee Surg Sports Traumatol Arthrosc 25(2):390\u0026ndash;396\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Meniscus MRI Pediatric Sport Medicine","lastPublishedDoi":"10.21203/rs.3.rs-7569349/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7569349/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eBackgrond: The meniscus plays a pivotal role in knee joint function, and it is widely recognized that precise trimming or suturing of the meniscus yields superior outcomes. However, treatment standards for pediatric meniscal injuries cannot be directly extrapolated to adults. This study utilized magnetic resonance imaging data to assess the width and height of the meniscus at multiple sites in children across different age groups, aiming to investigate age-related growth and development patterns of the meniscus and contribute to promote treatment guidelines for pediatric patients.\u003c/p\u003e\u003cp\u003eData and METHODS: Retrospective collection of magnetic resonance imaging data from pediatric patients treated at our hospital between 2015 and 2023 was conducted. Exclusion criteria encompassed meniscal injuries, deformities, as well as synovial accumulation related to knee joint diseases that do not represent normal meniscal status. Measurements were taken for the width and height of both medial and lateral menisci at multiple sites, followed by statistical analysis correlating these measurements with age.\u003c/p\u003e\u003cp\u003eResults: Meniscal volume demonstrated a significant increase with age (P\u0026thinsp;\u0026lt;\u0026thinsp;0.01). Sites showing statistically significant volume increases were observed in 75% of cases aged 3\u0026ndash;11 years old; conversely, no statistically significant volume increases were found in 91.7% of cases aged 12\u0026ndash;17 years old. When comparing symmetry between medial and lateral menisci sites, it was noted that lateral menisci exhibited significantly higher measurement values (P\u0026thinsp;\u0026lt;\u0026thinsp;0.01), albeit with a small mean difference.\u003c/p\u003e\u003cp\u003eConclusions: As individuals matured, there was a trend towards centralized transition from immature to mature volumes across different sites within the meniscus; this growth tends to stabilize around 11\u0026ndash;12 years old before approaching an adult-like shape at 15\u0026ndash;17 years old. Prior to this stage, the volume falls below adult standards. While there was a statistical difference when comparing volumes between corresponding inner and outer sites on each side of the knee joint's central axis, this disparity was not deemed clinically significant.\u003c/p\u003e","manuscriptTitle":"The multi-site volume of the meniscus in nuclear magnetic resonance images of children demonstrates an age-related increase.","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-22 09:33:23","doi":"10.21203/rs.3.rs-7569349/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"5b1bc445-1b3b-4eef-bd6d-0db7073b43cd","owner":[],"postedDate":"September 22nd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-11-03T10:38:48+00:00","versionOfRecord":[],"versionCreatedAt":"2025-09-22 09:33:23","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7569349","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7569349","identity":"rs-7569349","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}