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Knee Surgery, Sports Traumatology, Arthroscopy

Published in:

01-03-2019 | KNEE

Using only MRI is moderately reliable in the prediction of meniscal tear reparability

Authors: Abdulhamit Misir, Turan Bilge Kizkapan, Kadir Ilker Yildiz, Yavuz Arikan, Rasit Ozcafer, Engin Cetinkaya

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 3/2019

Abstract

Purpose

The purpose of this study was to evaluate the role of surgeons’ experience with meniscal repairs and meniscectomy decisions, and to determine the factors affecting the disagreement between meniscal repairs and meniscectomy decisions.

Methods

In total, 223 patients with meniscal tears, 106 meniscal repairs, and 117 meniscectomies were included. Six orthopedic surgeons (3: > 5 years; 3: < 5 years’ arthroscopy experience) were blinded, and they independently reviewed all preoperative MR images for over a month. Their reviews were compared with arthroscopic interventions performed by a surgeon with > 10 years’ arthroscopy experience. Reparability-associated factors were also evaluated using multivariate logistic regression.

Results

The first and second evaluation results did not differ significantly between groups (n.s.). There was good agreement between MRI predictions and arthroscopic interventions for both groups (< 5 years’ experience: k = 0.248, agreement 62.3%; > 5 years’ experience: k = 0.351, agreement 67.3%). Sex, side, and distance of tear from the meniscocapsular junction were not significantly different between agreements and disagreements. Disagreement regarding meniscectomy was significantly higher than those regarding meniscus repair (p = 0.002). Concomitant anterior cruciate ligament (ACL) injury, osteochondral lesions, and medial meniscal tear increased the likelihood of meniscal repair (p = 0.0063, p = 0.0010, and p = 0.0369, respectively). An increased risk of disagreement between MRI and surgical procedure was found in the presence of bucket-handle, horizontal or complex tear, chronic tear, high sports activity and expectation level.

Conclusion

Surgeon’s experience level may influence the prediction of meniscus reparability. Concomitant ACL injury, osteochondral lesions, and presence of medial meniscal tear increase the likelihood of meniscal repair. Tear type, tear chronicity, patient’s activity and expectation level may influence the surgeon’s operative decision in addition to MRI.

Level of evidence

III.

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Title: Using only MRI is moderately reliable in the prediction of meniscal tear reparability
Authors: Abdulhamit Misir
Turan Bilge Kizkapan
Kadir Ilker Yildiz
Yavuz Arikan
Rasit Ozcafer
Engin Cetinkaya
Publication date: 01-03-2019
Publisher: Springer Berlin Heidelberg
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 3/2019
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-018-5187-9

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Using only MRI is moderately reliable in the prediction of meniscal tear reparability

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

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