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The Modified PROMT Score: A Better Prognosticative Tool to Assess Traumatic Meniscal Tear Reparability

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Abstract

Background

Considering various factors that influence meniscal repairability, Ortho One PROMT score (OPS) was proposed in 2019. With an increased understanding of factors influencing meniscal repair and by analysis of OPS predictions and repair results, a modified PROMT score (MPS) has been formulated. The objective of this study is to assess the superiority of MPS over OPS.

Methods

Age, chronicity, and pattern of tears were found to be important contributors to false-negative results of OPS. Considering these factors, MPS was designed. A prospective, double-blinded study was conducted between November 2020 and May 2021. Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, positive predictive value, negative predictive value, and accuracy of both scores were calculated. Receiver Operating Characteristic (ROC) curve was plotted.

Results

Of 133 meniscal tears, 100 met the inclusion criteria. In predicting meniscal repairability, OPS demonstrated sensitivity and specificity of 90.32% and 83.33% medially and 64.71% and 79.41% laterally. MPS had sensitivity and specificity of 96.77% and 88.89% medially and 82.35% and 88.24% laterally. Both scores showed good statistical significance (p < 0.05) in predicting meniscal reparability. For medial meniscus repairability, area under the ROC curve was 0.868 for OPS and 0.928 for MPS. For lateral repairability, the area under the curve was 0.721 for OPS and 0.853 for MPS.

Conclusion

MPS will serve as a simple and more effective tool for surgeons to predict meniscal repairability, thus enhancing their pre-surgical preparedness. This tool will also help surgeons to realistically counsel their patients and to achieve optimal patient.

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Funding

No external funding was received for study.

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Authors and Affiliations

  1. Ortho One Orthopaedic Speciality Centre, Singanallur, Coimbatore, Tamil Nadu, 641005, India

    Shyam Sundar, Prashanth Pandian, Girinivasan Chellamuthu, Santosh Sahanand & David V. Rajan

  2. Chettinad Hospital and Research Institute, CARE, Chennai, India

    Prashanth Pandian

  3. Saveetha Medical College and Hospital, SIMATS, Chennai, India

    Girinivasan Chellamuthu

  4. Ramesh Hospital, Guntur, India

    Prashanth Chalasani

  5. Fortis Hospital, Bangalore, India

    Vinay Kumaraswamy

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  1. Shyam Sundar
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  2. Prashanth Pandian
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  4. Prashanth Chalasani
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  5. Vinay Kumaraswamy
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  6. Santosh Sahanand
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  7. David V. Rajan
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Contributions

SS, PP—conceptualization, data curation, formal analysis, investigations, methodology, administration, resources, supervision, validation, visualization, writing original drafts and reviewing drafts. GC, PC—conceptualization, data curation, formal analysis, investigations, methodology, supervision, validation, visualization, writing original drafts and reviewing drafts. VK, SS, DVR—conceptualization, data curation, formal analysis, investigations, methodology, administration, resources, supervision, validation, and visualization.

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Correspondence to Girinivasan Chellamuthu.

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Sundar, S., Pandian, P., Chellamuthu, G. et al. The Modified PROMT Score: A Better Prognosticative Tool to Assess Traumatic Meniscal Tear Reparability. JOIO 57, 495–504 (2023). https://doi.org/10.1007/s43465-023-00838-1

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  • DOI: https://doi.org/10.1007/s43465-023-00838-1

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