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Extrusion, meniscal signal change, loss of shape, synovitis and bone marrow oedema are reliable scoring parameters to assess MRI appearance post meniscal transplant

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Meniscal allograft transplantation (MAT) has shown good promise in restoring normal knee joint biomechanics in a meniscal deficient patient. However, MRI appearance of the meniscal allograft is often questioned and raises concerns of its viability and function. This paper aims to introduce and validate a new scoring system for MAT MRI appearance at 12 months [MRI appearance in Meniscal Transplant Score (MIMS)], using key changes such as extrusion, meniscal signal change, loss of shape, synovitis and bone marrow oedema.

Methods

A retrospective analysis of 10 patients from a single surgeon series was conducted. All MAT were performed with soft tissue fixation technique. MRI was performed at 12 months post-transplant with two independent consultant musculoskeletal radiologists and one experienced meniscal transplant surgeon scoring the images obtained. Interobserver agreement and intraclass correlation were measured.

Results

Interobserver agreement between examiners on individual features of the MIMS was superior for tibial bone oedema, substantial for meniscal extrusion and femoral bone oedema, moderate for meniscal shape and synovitis, and fair for meniscal signal changes. Absolute agreement between raters found good reliability (ICC = 0.774; 95% 0.359, 0.960) for single measures and excellent reliability (ICC = 0.911; 95% 0.627, 0.986) for average measures.

Conclusion

MIMS is a reliable method of evaluating the meniscal allograft transplant 12 months post-transplant. Further research with larger MAT cohort groups and patient reported outcome measures may be helpful to correlate its clinical significance and guide further management.

Level of evidence

Level III.

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Acknowledgements

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Funding

There was no funding involved in this study.

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Authors and Affiliations

  1. University Hospital Coventry and Warwickshire NHS Trust (UHCW), Coventry, West Midlands, UK

    Iswadi Damasena, Laura Asplin, Charles Hutchinson, Rachit Shah & Tim Spalding

  2. Box Hill Hospital, 8 Arnold Street, Box Hill, Melbourne, VIC, 3128, Australia

    Iswadi Damasena & James R. Onggo

Authors
  1. Iswadi Damasena
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  2. James R. Onggo
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  3. Laura Asplin
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  4. Charles Hutchinson
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  5. Rachit Shah
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Contributions

ID: idea conception, data collection, data analysis, data interpretation, manuscript drafting and review; JRO: data interpretation, manuscript drafting and review; LA: data collection, data interpretation. CH: data collection, scoring of images; RS: data collection, scoring of images; TS: idea conception, data collection, scoring of Images, data interpretation, manuscript review.

Corresponding author

Correspondence to James R. Onggo.

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Ethical approval

Outcome data collection and analysis was approved by the Research and Development Department at University Hospital Coventry and Warwickshire NHS Trust.

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Informed consent was obtained from participants prior to the study. Participants were required to sign a consent form.

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Damasena, I., Onggo, J.R., Asplin, L. et al. Extrusion, meniscal signal change, loss of shape, synovitis and bone marrow oedema are reliable scoring parameters to assess MRI appearance post meniscal transplant. Knee Surg Sports Traumatol Arthrosc 30, 1527–1534 (2022). https://doi.org/10.1007/s00167-021-06720-7

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  • DOI: https://doi.org/10.1007/s00167-021-06720-7

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