Purpose and hypothesisIn preoperative sizing for meniscal transplantation, most authors take into consideration the length and width of the original meniscus, but not its height. This study aimed at evaluating (1) whether the meniscal height is associated with the meniscal length and width, (2) whether the heights of the meniscal segments are associated with the individual’s anthropometric data, (3) whether the heights of the meniscal segments are associated with each other in the same meniscus, and (4) the degree of symmetry of the meniscal dimensions between the right and left knees.MethodsIn this cross-sectional, observational study, two independent radiologists measured the meniscal length, width and height in knee magnetic resonance imaging scans obtained from 25 patients with patello-femoral pain syndrome. Reproducibility of measurements was calculated with intraclass correlation coefficients. Associations between the anthropometric data and the meniscal measurements, the meniscal length and width versus height, and the heights of the meniscal segments in the same meniscus were examined with Pearson’s correlation.ResultsInter-observer reliability was excellent (>0.8) for length and height and good (0.6–0.8) for width measurements. There was also excellent agreement (>0.8) for the length and width of the menisci in the right and left knees. The heights of the horns of the lateral meniscus showed good agreement (0.6–0.8), while the heights of the other meniscal segments had excellent agreement between the sides (>0.8). There were significant associations with generally low (r < 0.5) correlation between the heights of the meniscal segments and the lengths and widths of the menisci, between the meniscal height and anthropometric data, and between the heights of the meniscal segments in the same meniscus. Correlations between anthropometric data and meniscal length and width were generally high (r > 0.7).ConclusionsThere was excellent agreement between the meniscal dimensions of the right and left knees, and a weak association between the meniscal height with the meniscal width and length, between the height of the menisci with anthropometric data and between the heights of the segments in the same meniscus. The height of the meniscal segments may be a new variable in preoperative meniscal measurement.
Resumo Objetivo Comparar a ressonância magnética (RM) usando uma bobina corporal e tomografia computadorizada (TC) na medição da distância tubérculo tibial-sulco troclear (TT-ST) e as distâncias tendão patelar-sulco troclear cartilaginoso (TP-STC), e avaliar a confiabilidade interavaliador. Métodos O grupo de estudo consistiu em 34 joelhos de 17 indivíduos assintomáticos sem história de patologia, trauma ou cirurgia no joelho. Uma tomografia computadorizada (TC) de baixa dose e uma sequência axial de RM ponderada em T1 dos joelhos foram realizadas com padronização rigorosa do posicionamento com extensão total dos joelhos e pés paralelos. Dois radiologistas musculoesqueléticos realizaram as medidas de forma independente. A confiabilidade das distâncias TT-ST e TP-STC na TC (17,1 ± 4,2 mm e 17,3 ± 4,2 mm) e RM (16,2 ± 3,7 mm e 16,5 ± 4,1 mm), foi avaliada pelo coeficiente de correlação intraclasse (CCI [2,1)]) e gráficos Bland-Altman, bem como a confiabilidade entre avaliadores para ambos os métodos. Resultados Boa confiabilidade e concordância foram observadas entre as medidas de TC e RM para TT-ST e TP-STC com um CCI de 0,774 (p < 0,001) e 0,743 (p < 0,001), respectivamente, e nenhum viés sistemático foi observado. A confiabilidade entre avaliadores foi excelente para todas as medições em ambos os métodos de imagem. Conclusão Este foi o primeiro estudo que comparou a RM usando bobina de corpo com a TC na medição da distância TT-ST, com a implicação clínica potencial de que a TC neste cenário clínico poderia ser evitada.
Objective To evaluate the intra- and interobserver reliability of the Lee et al. classification for migrated lumbar disc herniations. Methods In 2018, Ahn Y. et al. demonstrated the accuracy of this classification for radiologists. However, magnetic resonance images are often interpreted by orthopedists. Thus, a cross-sectional study was conducted by evaluating the magnetic resonance images of 82 patients diagnosed with lumbar disc herniation. The images were evaluated by 4 physicians, 3 of whom were spinal orthopedic specialists and 1 of whom was a radiologist. The intra- and interobserver analysis was conducted using the percentage of concordance and the Kappa method. Results The report of the classifications used by the four observers had a higher proportion of “zone 3” and “zone 4” type classifications in both evaluation moments. The most affected anatomical levels were L5-S1 (48.2%) and L4-L5 (41.4%). The intra- and interobserver concordance, when comparing both moments evaluation of the complementary examinations of the participants involved, was classified as moderate and very good. Conclusions Lee’s classification presented moderate to very good intra- and interobserver reliability for the evaluation of migrated lumbar disc herniation. Level of evidence II; Retrospective Study.
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