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

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

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.

Methods

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.

Results

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).

Conclusions

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

II.

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Acknowledgments

We would like to thank Dr Elena Pizzo, Health Economist at Imperial College Business School, London, for her assistance in cost analysis.

Conflict of interest

We declare that we have no conflict of interest.

Author information

Authors and Affiliations

  1. Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK

    Nirav K. Patel

  2. Department of Trauma and Orthopaedic Surgery, The Royal Melbourne Hospital, Grattan Street, Parkville, VA, 3052, Australia

    Andrew Bucknill

  3. Department of Trauma and Orthopaedic Surgery, Hillingdon Hospital, Pield Heath Road, Uxbridge, Middlesex, UB8 3NN, UK

    David Ahearne

  4. Department of Physiotherapy, West Middlesex University Hospital, Twickenham Road, Isleworth, Middlesex, TW7 6AF, UK

    Janet Denning

  5. Department of Trauma and Orthopaedic Surgery, West Middlesex University Hospital, Twickenham Road, Isleworth, Middlesex, TW7 6AF, UK

    Kailash Desai

  6. Department of Clinical Imaging, West Middlesex University Hospital, Twickenham Road, Isleworth, TW7 6AF, UK

    Martin Watson

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  1. Nirav K. Patel
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Correspondence to Martin Watson.

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Patel, N.K., Bucknill, A., Ahearne, D. et al. Early magnetic resonance imaging in acute knee injury: a cost analysis. Knee Surg Sports Traumatol Arthrosc 20, 1152–1158 (2012). https://doi.org/10.1007/s00167-012-1926-5

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  • DOI: https://doi.org/10.1007/s00167-012-1926-5

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