Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 20, Issue 6, pp 1152–1158

Early magnetic resonance imaging in acute knee injury: a cost analysis

  • Nirav K. Patel
  • Andrew Bucknill
  • David Ahearne
  • Janet Denning
  • Kailash Desai
  • Martin Watson

DOI: 10.1007/s00167-012-1926-5

Cite this article as:
Patel, N.K., Bucknill, A., Ahearne, D. et al. Knee Surg Sports Traumatol Arthrosc (2012) 20: 1152. doi:10.1007/s00167-012-1926-5



Acute knee injury is common, and MRI is often only used when non-operative management fails because of limited availability. We investigated whether early MRI in acute knee injury is more clinically and cost-effective compared to conventional physiotherapy and reassessment.


All patients with acute indirect soft tissue knee injury referred to fracture clinic were approached. Recruited patients were randomised to either the MRI group: early MRI within 2 weeks or the control group: conventional management with physiotherapy. Patients were assessed in clinic initially, at 2 weeks and 3 months post-injury. Management costs were calculated for all patients until surgical treatment or discharge.


Forty-six patients were recruited: 23 in the MRI and 23 in the control group. Male sex and mean age were similar in the two groups. The total management cost of the MRI group was £16,127 and control group was £16,170, with a similar mean cost per patient (NS). The MRI group had less mean physiotherapy (2.5 ± 1.9 vs. 5.1 ± 3.5, p < 0.01) and outpatient appointments (NS). Median time to surgery and time off work was less in the MRI group (NS). The MRI group had less pain (p < 0.05), less activity limitation (p = 0.04) and better satisfaction (p = 0.04).


Early MRI in acute knee injury facilitates faster diagnosis and management of internal derangement at a cost comparable to conventional treatment. Moreover, patients had significantly less time off work with improved pain, activity limitation and satisfaction scores.

Level of evidence



Magnetic resonance imaging Acute knee injury Cost-effectiveness Randomised controlled trial 

Supplementary material

167_2012_1926_MOESM1_ESM.doc (218 kb)
Supplementary material 1 (DOC 218 kb)

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Nirav K. Patel
    • 1
  • Andrew Bucknill
    • 2
  • David Ahearne
    • 3
  • Janet Denning
    • 4
  • Kailash Desai
    • 5
  • Martin Watson
    • 6
  1. 1.Royal National Orthopaedic HospitalBrockley Hill, Stanmore, MiddlesexUK
  2. 2.Department of Trauma and Orthopaedic SurgeryThe Royal Melbourne HospitalParkvilleAustralia
  3. 3.Department of Trauma and Orthopaedic SurgeryHillingdon HospitalUxbridge, MiddlesexUK
  4. 4.Department of PhysiotherapyWest Middlesex University HospitalIsleworth, MiddlesexUK
  5. 5.Department of Trauma and Orthopaedic SurgeryWest Middlesex University HospitalIsleworth, MiddlesexUK
  6. 6.Department of Clinical ImagingWest Middlesex University HospitalIsleworthUK

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