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

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

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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Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Şanlıurfa Eğitim ve Araştırma Hastanesi, Ortopedi ve Travmatoloji Bölümü, Akpıyar mah. 4061. Sk. Yaşamkent Park evleri no: 29 B blok d: 21 Karaköprü, Şanlıurfa, Turkey

    Abdulhamit Misir

  2. Bursa Çekirge Devlet Hastanesi, Bursa, Turkey

    Turan Bilge Kizkapan

  3. Metin Sabancı Baltalimanı Kemik Hastalıkları Eğitim ve Araştırma Hastanesi, Istanbul, Turkey

    Kadir Ilker Yildiz, Yavuz Arikan, Rasit Ozcafer & Engin Cetinkaya

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  1. Abdulhamit Misir
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  2. Turan Bilge Kizkapan
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  3. Kadir Ilker Yildiz
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  4. Yavuz Arikan
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  5. Rasit Ozcafer
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  6. Engin Cetinkaya
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Corresponding author

Correspondence to Abdulhamit Misir.

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Conflict of interest

Abdulhamit Misir, Turan Bilge Kizkapan, Kadir Ilker Yildiz, Yavuz Arikan, Rasit Ozcafer and Engin Cetinkaya declare that they have no conflict of interest.

Ethical approval

Metin Sabancı Baltalimanı Kemik Hastalıkları Eğitim ve Araştırma Hastanesi Institutional review board approved the study protocol (Approval date/number: 22.03.2018/26).

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Misir, A., Kizkapan, T.B., Yildiz, K.I. et al. Using only MRI is moderately reliable in the prediction of meniscal tear reparability. Knee Surg Sports Traumatol Arthrosc 27, 898–904 (2019). https://doi.org/10.1007/s00167-018-5187-9

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  • DOI: https://doi.org/10.1007/s00167-018-5187-9

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