A new scoring system for prediction of meniscal repair in traumatic meniscal tears

Abstract

Purpose

Traditionally, MRI has not been used to predict meniscus tear reparability. An attempt has been made in this study to predict meniscal reparability using MRI, and a new scoring system to help with the same has been developed and tested.

Methods

Thirty repaired menisci were compared with equal number of meniscectomy cases retrospectively. Various clinical and radiological (radiographs and MRI) characteristics like chronicity of tear, pattern of tear, etc, were tabulated. Based on their association with the outcome of repair or meniscectomy, odds ratio of each attribute were calculated. A scoring system—Ortho One PROMT Score (Prediction of Reparability of Meniscal Tears)—to predict meniscal repair was formulated. Using this score, meniscus surgery outcomes were prospectively predicted in 120 cases and results tabulated.

Results

The newly devised Ortho One PROMT score predicted medial meniscus repair with a sensitivity of 90.9% and a specificity of 93.2% and medial meniscectomy with a sensitivity of 93.2% and a specificity of 90.9%. It predicts lateral meniscus repair with a sensitivity of 69.2% of patients and lateral meniscectomy with a sensitivity of 78.8% of patients.

Conclusion

Ortho One PROMT score is a useful scoring system to predict the outcomes of meniscus surgery preoperatively. It uses a combination of clinical and radiological (MRI and plain radiograph) characteristics. With this scoring system, both the surgeon and the patient are better prepared preoperatively regarding the outcome of a particular meniscus surgery. The scoring shall make day-to-day arthroscopic meniscus surgery less stressful.

Level of evidence

III.

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Fig. 1
Fig. 2

Abbreviations

PROMT:

Prediction of Reparability of Meniscus Tears

BHMT:

Bucket handle meniscus tear

MRI:

Magnetic resonance imaging

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Funding

This was a self funded study. No external funding was used.

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Affiliations

Authors

Contributions

Conception and design: VK, Sh Su, and DVR. Acquisition of data: VK, Sh Su AGR, DVR, KS, SA Sa, and DS. Analysis: VK and Sh Su.

Corresponding author

Correspondence to Vinay Kumaraswamy.

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Conflict of interest

There are no conflict of interest involved in the study.

Ethical approval

All procedures carried out in our study have been in accordance with the ethical standards of the national research committee and is in accordance with the 1964 Hensinki declaration and its later amendments or comparable ethical standards.

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Kumaraswamy, V., Ramaswamy, A.G., Sundar, S. et al. A new scoring system for prediction of meniscal repair in traumatic meniscal tears. Knee Surg Sports Traumatol Arthrosc 27, 3454–3460 (2019). https://doi.org/10.1007/s00167-019-05377-7

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Keywords

  • Meniscus repair
  • Meniscectomy
  • Scoring
  • Prediction