The meniscal flounce: A valuable arthroscopic sign

PurposeThe purpose of this study was to characterise the incidence and significance of the meniscal flounce.Type of studyProspective Cohort Study.MethodA prospective study of 1088 consecutive knee arthroscopies.ResultsIntact menisci tended to have a flounce of characteristic size and position. The presence of this ‘normal’ flounce was closely correlated with an intact meniscus (p < 0.0001). For the medial meniscus with a small flounce in zone 3 the sensitivity, specificity, and positive predictive value (PPV) for an intact medial meniscus were 68.5%; 92.9%; and 92.1% respectively. Conversely the presence of meniscal pathology correlated closely with either an absent or abnormal flounce (p < 0.0001). The absence of a medial flounce had sensitivity, specificity, and PPV for a meniscal tear of 82.8%; 84.9%; and 81.9% respectively.ConclusionsThe findings of this study are useful for arthroscopists especially when there is difficulty visualising all of the posterior half of the meniscus. In this situation the presence of a normal flounce is likely to signify an intact meniscus. However the presence of an abnormal or absent flounce may be the sign of an occult meniscal tear requiring better exposure.