Reliability of magnetic resonance imaging in evaluating meniscal and cartilage injuries in anterior cruciate ligament-deficient knees

Wong, Kenneth Pak Leung; Han, Audrey Xinyun; Wong, Jeannie Leh Ying; Lee, Dave Yee Han

doi:10.1007/s00167-016-4211-1

Cited by 26 publications

(22 citation statements)

References 33 publications

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“…MRI is a reliable tool for assessing meniscal tears and cartilage defects preoperatively, but it was reportedly more accurate for evaluating MMT than LMT. 30,31 It has also been reported that the sensitivity and negative predictive value for meniscal tears decrease in the presence of ACL tears, especially for LMT. 32 Thus, compared with MMT, the incidence of LMT in MRI studies may be underestimated in our series.…”

Section: Discussionmentioning

confidence: 97%

Correlation of Meniscal Tear with Timing of Anterior Cruciate Ligament Reconstruction in Patients without Initially Concurrent Meniscal Tear

et al. 2018

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The incidence of meniscal tear was reported to increase with the delay of anterior cruciate ligament reconstruction (ACLR). The tear may occur concurrently with the ACL injury or after the ACL injury. Few studies had focused on the patients whose meniscus is intact during ACL injury. We determined the correlation between timing of surgery and incidence of meniscal tears in ACL-deficient knees with initially intact meniscus. We retrospectively reviewed 387 patients who had undergone primary ACLR. Time of initial ACL injury, magnetic resonance imaging (MRI) examination, and surgery was recorded. The MRI was reviewed by experienced radiologic and orthopaedic doctors. Intraoperative arthroscopic images were also obtained and reviewed. The type of tear noted during surgery was classified according to the modification of International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine classification of meniscal tears. Patients were divided into early (surgery within 12 months from injury) and late surgery group (surgery at more than 12 months from injury). There were 216 patients with intact medial meniscus and 257 patients with intact lateral meniscus on the postinjury MRI study. The incidence of medial meniscus tear (MMT) was significantly higher than lateral meniscus tear (LMT) during the ACLR (33.8 vs. 19.8%, p < 0.001). The incidence of MMT is higher in late group than in early group (53.7 vs. 29.1%, p = 0.004, odds ratio= 2.815). The incidence of LMT is mildly higher in late group but without statistics significance (23.8 vs. 18.6%, p = 0.364). In both MMT and LMT, the most common injury pattern observed was a longitudinal tear. The incidence of each type is not different between early and late group. For patients without concurrent meniscal injuries with the ACL tear, the incidence of MMT significantly increased if ACLR was performed more than 12 months after injury. The medial meniscus was more prone to injury than the lateral meniscus in chronic ACL-deficient knee. ACLR should be performed earlier to reduce the risk of meniscal tears for patients without initially concurrent meniscal tear.

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Section: Discussionmentioning

confidence: 97%

Correlation of Meniscal Tear with Timing of Anterior Cruciate Ligament Reconstruction in Patients without Initially Concurrent Meniscal Tear

et al. 2018

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“…In our study, we found 70% sensitivity with a specificity of 85%. It is well demonstrated in literature that MRI has a lower sensitivity in detecting lateral meniscus lesions, which some authors attribute to its anatomical structure [41]. Moreover, the location of a lesion impacts the diagnostic accuracy of MRI.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Diagnostic Accuracy of Physical Examination and MRI in the Most Common Knee Injuries

et al. 2019

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Purpose: This study evaluated the diagnostic accuracy of physical examination and magnetic resonance imaging (MRI) in knee injuries. Methods: Ninety-six patients at a regional hospital were included in the study. Each participant underwent a physical examination in which menisci and ACL were evaluated. Knee joint MRI was collected from each patient. Physical examination and MRI scans were then compared with knee arthroscopy findings as a golden standard for meniscal and ligamentous lesions. The data were analyzed and specificity and sensitivity were calculated and correlated on receiver operating characteristics (ROC) curves. Results: Knee arthroscopy diagnosed 32 total ACL ruptures, 45 medial meniscus and 17 lateral meniscus lesions. Three patients were diagnosed with bilateral meniscal lesions. The highest sensitivities were the McMurray test (87.5%) for medial meniscus (MM) and the Thessaly test (70%) for lateral meniscus (LM). The most sensitive ACL test was Lachman (84.5%), whereas, the pivot shift and Lelli tests were the most specific (98.5%). MRI was highly sensitive for MM (96%) with specificity of 52%. MRI showed lower sensitivity (70%) and higher specificity (85.5%) for LM. The specificity of MRI for ACL rupture was 92%, with sensitivity only 75%. Conclusion: McMurray and Apley tests for meniscal lesions seem the most appropriate in daily practice. A combination of lever signs, pivot shifts (PSs) and Lachman tests showed the best sensitivity and specificity in detecting ACL deficiency, and was superior to MRI.

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“…MRI and arthroscopy are still the benchmark non-invasive and invasive methods for the evaluation of meniscal tears, respectively. 21 - 23 …”

Section: Clinical Evaluationmentioning

confidence: 99%

Modern treatment of meniscal tears

et al. 2018

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The complex ultrastructure of the meniscus determines its vital functions for the knee, the lower extremity, and the body.The most recent concise, reliable, and valid classification system for meniscal tears is the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) Classification, which takes into account the subsequent parameters: tear depth, tear pattern, tear length, tear location/rim width, radial location, location according to the popliteal hiatus, and quality of the meniscal tissue.It is the orthopaedic surgeon’s responsibility to combine clinical information, radiological images, and clinical experience in an effort to individualize management of meniscal tears, taking into account factors related to the patient and lesion.Surgeons should strive not to operate in most cases, but to protect, repair or reconstruct, in order to prevent early development of osteoarthritis by restoring the native structure, function, and biomechanics of the meniscus.Currently, there are three main methods of modern surgical management of meniscus tears: arthroscopic partial meniscectomy; meniscal repair with or without augmentation techniques; and meniscal reconstruction. Meniscus surgery has come a long way from the old slogan, “If it is torn, take it out!” to the currently accepted slogan, “Save the meniscus!” which has guided evolving modern treatment methods for meniscal tears. This last slogan will probably constitute the basis for newer alternative biological treatment methods in the future.Cite this article: EFORT Open Rev 2018;3 DOI: 10.1302/2058-5241.3.170067.

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Reliability of magnetic resonance imaging in evaluating meniscal and cartilage injuries in anterior cruciate ligament-deficient knees

Abstract: IV.

Cited by 26 publications

References 33 publications

Correlation of Meniscal Tear with Timing of Anterior Cruciate Ligament Reconstruction in Patients without Initially Concurrent Meniscal Tear

Correlation of Meniscal Tear with Timing of Anterior Cruciate Ligament Reconstruction in Patients without Initially Concurrent Meniscal Tear

Comparison of Diagnostic Accuracy of Physical Examination and MRI in the Most Common Knee Injuries

Modern treatment of meniscal tears

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