Meniscal injuries: detection using MR imaging.

Reicher, Murray A.; Hartzman, S; Duckwiler, Gary; Bassett, Lawrence W.; Anderson, Libby; Gold, R H

doi:10.1148/radiology.159.3.3754645

Cited by 184 publications

(65 citation statements)

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“…Arthroscopy was used to verify the results. Our data show that the MRI investigation has a higher sensitivity and specificity than reported by previous investigators [10,11,13,22,23].…”

Section: Discussioncontrasting

confidence: 53%

Economic Considerations for the Diagnosis and Therapy of Meniscal Lesions: Can Magnetic Resonance Imaging Help Reduce the Expense?

et al. 1997

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With magnetic resonance imaging (MRI) the surgeon has such an effective diagnostic tool in the diagnosis of a meniscal lesion that the times of diagnostic arthroscopy should be in the past. A total of 823 patients with clinically diagnosed meniscal lesions were divided into two groups: group A, 143 patients underwent MRI and 75 of those arthroscopy; group B, 680 patients, 201 (30%) of whom were operated after being only clinically examined. MRI was done on a Siemens Medical System Magnetom 1.5 Tesla with a 256 x 256 matrix. Spinal echo and gradient echo images were performed with slices of 2 to 4 mm thickness. All meniscal tears were graded according to Reicher and Crues, respectively. Grades III and IV were judged to be positive for a meniscal lesion. Arthroscopy was carried out under general anesthesia and the usual technique. The MRI revealed the following results: Medial meniscus: accuracy 95%, positive predictive value (PPV) 92%, negative predictive value (NPV) 95%, sensitivity 98%, and specificity 82%, lateral meniscus: accuracy 97%, PPV 92%, NPV 98%, sensitivity 94%, and specificity 98%. The overall values for MRI of the medial and lateral menisci combined were: accuracy 96%, PPV 93%, NPV 98%, sensitivity 96%, and specificity 90%. The clinical examination often failed to diagnose a meniscal lesion: accuracy 64%, PPV 59%, NPV 89%, sensitivity 96%, and specificity 33% for the medial meniscus. For the lateral meniscus the accuracy was 91%, PPV 61%, NPV 98%, sensitivity 89%, and specificity 91%. The overall values for the clinical investigation of the medial and lateral menisci combined were: accuracy 78%, PPV 60%, NPV 94%, sensitivity 93%, and specificity 62%. Investigation of all 201 patients operated from group B with MRI would have cost $160,800. The cost of 30% fewer arthroscopies would have been $562,800--in total $723,600. The operation of all 201 patients cost $804,000. Hence about $80,000 could have been saved by scanning all 201 patients and therefore reduce the rate of diagnostic arthroscopies.

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“…Arthroscopy was used to verify the results. Our data show that the MRI investigation has a higher sensitivity and specificity than reported by previous investigators [10,11,13,22,23].…”

Section: Discussioncontrasting

confidence: 53%

Economic Considerations for the Diagnosis and Therapy of Meniscal Lesions: Can Magnetic Resonance Imaging Help Reduce the Expense?

et al. 1997

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“…MRI images were evaluated by the senior author according to the classification of Reicher et al [34]. Grade I is a homogenously black meniscus (no tear), grade II shows increased signal within the meniscus (tear unlikely), grade III shows linear regions of increased density within the meniscus reaching cartilage surface (definitive tear) and grade IV gross distortion of normal meniscal shape.…”

Section: Evaluation Methodsmentioning

confidence: 99%

Arthroscopic meniscal repair with an absorbable screw: results and surgical technique

Hantes

Kotsovolos²,

Mastrokalos³

et al. 2004

Knee Surg Sports Traumatol Arthrosc

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The results of a new method for arthroscopic all-inside meniscus repair using a biodegradable cannulated screw (Clearfix meniscal screw) were assessed in a medium-term follow-up prospective study. The Clearfix meniscal screw system consists of delivery cannulae, screw driver, and screw implants. After tear debridement, a screw is located on the driver and passed through the cannula to the insertion site, holding the two sides of the tear together under linear compression. Forty-eight patients (48 repairs) with a mean age of 32.7 years were included in the study. Ligament stabilizing procedures were done in 39 patients (81%) who had anterior cruciate ligament deficient knees. Only longitudinal lesions in the red/red or red/white zone were repaired. Follow-up averaged 19 months, with a range from 12 to 48 months. Patients were evaluated using clinical examination, the "Orthopaedische Arbeitsgemeinschaft Knie (OAK)" knee evaluation scheme and magnetic resonance imaging (MRI). Criteria for clinical success included absence of joint-line tenderness, absence of swelling and a negative McMurray test. Postoperatively, there were no complications directly associated with the device. Twelve of 48 repaired menisci (25%) were considered failures according to the above-mentioned criteria. According to the OAK knee evaluation scheme, 38 patients (79%) had an excellent or good result. MRI, however, showed persisting grade III or IV lesions in 35 patients (73%). Analysis showed that age, length of tear, and simultaneous anterior cruciate ligament reconstruction did not affect the clinical outcome. In contrast, risk factors for failure of meniscus repair are chronicity of injury, location of tear more than 3 mm from the meniscosynovial junction and meniscus side (medial).

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“…Ten millilitres of autologous blood was taken from the antecubital vein with the outer syringe and placed into the Arthrex © C I C E d i z i o n i I n t e r n a z i o n a l i the meniscus, the patient was placed in a standardized position and wore a knee splint for reproducible alignment of the leg. Halt of progression was determined when the same grade of meniscal lesion according to Reicher et al 4 was present during follow up examination with same or less size and signal intensity of the lesion. Imaging evaluation was performed in a blinded manner by two independent, experienced radiologists.…”

Section: Methodsmentioning

confidence: 99%

Percutaneous injections of Platelet rich plasma for treatment of intrasubstance meniscal lesions

Blanke¹,

Vavken

Haenle³

et al. 2015

MLTJ

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the time of follow up MRI after six months. The ttest was used to determine statistical differences. Results: four of ten patients (40%) showed decrease of meniscal lesion in follow up MRI after six months. Nine of ten patients (90%) complained about short episodes of heavy pain after the injections with average NRS-Score of 7.9 at daily loads after the last injection. Six of ten patients (60%) showed Improvement of NRS-Score at final follow up. Average NRS-Score improved significantly (p=0.027) from 6.9 before injections to 4.5 six month after treatment. Six of ten patients (60%) reported increase of sports activity compared to the situation before injections. In four patients (40%) additional surgical treatment was necessary because of persistent knee pain or progression of meniscal lesion. Conclusions: percutaneous injections of PRP have the ability to achieve pain relief and halt of progression on MRI over 6 months in patients with grade 2 meniscal lesions. Therefore it could be considered as a treatment option in patients with persisting pain. Level of evidence: IV.

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Meniscal injuries: detection using MR imaging.

Cited by 184 publications

References 0 publications

Economic Considerations for the Diagnosis and Therapy of Meniscal Lesions: Can Magnetic Resonance Imaging Help Reduce the Expense?

Economic Considerations for the Diagnosis and Therapy of Meniscal Lesions: Can Magnetic Resonance Imaging Help Reduce the Expense?

Arthroscopic meniscal repair with an absorbable screw: results and surgical technique

Percutaneous injections of Platelet rich plasma for treatment of intrasubstance meniscal lesions

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