Role of MRI in predicting meniscal tear reparability

Felisaz, Paolo Florent; Alessandrino, Francesco; Perelli, Simone; Zanon, Giacomo; Benazzo, Francesco; Calliada, Fabrizio; Sammarchi, Luigi

doi:10.1007/s00256-017-2700-z

Cited by 10 publications

(19 citation statements)

References 20 publications

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“…Although the classification tree method described here demonstrated a reasonable degree of accuracy (72%) among the patients in our data set, this degree of accuracy was not improved in comparison with previously described methods. 1,5,14 MRI has been reported to be sensitive and specific for the diagnosis of meniscus tears. 16 One systematic review and meta-analysis of 29 articles showed a pooled weight sensitivity of 93.3% for the diagnosis of medial meniscus tears and 79.3% for lateral meniscal tears.…”

Section: Discussionmentioning

confidence: 99%

“…Previous authors have suggested that 3-T MRI may help eliminate inconsistencies regarding the reported rate of accurately predicting meniscal tear reparability, 1,5,12,14 noting that a higher spatial resolution could help resolve any potential ambiguity experienced during the image review process. To our knowledge, the current study is the first to characterize the use of 3-T MRI exclusively to evaluate meniscus tear reparability and thus significantly contributes to the existing literature on this topic.…”

Section: Discussionmentioning

confidence: 99%

“…The modified Felisaz method (Figure 2) was based on the reparability algorithm described by Felisaz et al, 5 who emphasized tear pattern as a key criterion when characterizing reparability. The modified Felisaz method is identical to that of the original algorithm, except that in the modified version, tears were considered reparable as long as at least some component of the tear measured a distance of <5 mm from the meniscocapsular junction.…”

Section: Methodsmentioning

confidence: 99%

“…We also aimed to determine whether these MRI findings could improve the accuracy of predicting meniscus tear reparability via the application of previously described methods. 1,5,10 In addition, we sought to compare the results of previously described methods with a new meniscal tear reparability prediction method based on the most influential imaging parameters identified in our study population. Although it is unclear whether 3-T MRI has any meniscal tear diagnostic advantage over 1.5-T MRI, 7,11,22 we hypothesized that the higher field strength of 3-T MRI would result in greater accuracy than 1.5-T MRI with regard to the prediction of meniscus reparability.…”

mentioning

confidence: 99%

“…However, these different methods report varying degrees of success for predicting meniscal tear reparability. For example, Felisaz et al 5 stratified meniscal injuries by tear pattern and reported a sensitivity of 85%, a specificity of 79%, and an accuracy of 83% with regard to predicting meniscus tear reparability in the setting of preoperative 1.5-T MRI. The Ortho One PROMT scoring method (based on 1.5-T MRI) for predicting meniscal reparability includes factors such as age, chronicity of the injury, findings on plain radiographs, specified zone of the tear, and tear pattern.…”

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confidence: 99%

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The Reliability of 3-T Magnetic Resonance Imaging to Identify Arthroscopic Features of Meniscal Tears and Its Utility to Predict Meniscal Tear Reparability

et al. 2021

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Background: The ability to predict meniscus tear reparability based on preoperative magnetic resonance imaging (MRI) is desirable for postoperative planning; however, the accuracy of predictive methods varies widely within the orthopaedic and radiology literature. Purpose/Hypothesis: The purpose was to determine if the higher resolution offered by 3-T MRI improves the accuracy of predicting reparability compared with previous investigations using 1.5-T MRI. Our hypothesis was that a higher field strength of 3-T MRI would result in improved reliability assessments and predictions of meniscus tear reparability compared with previous studies utilizing a 1.5-T MRI platform. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: A total of 44 patients who underwent meniscus repair were matched by age, sex, and body mass index to 43 patients who underwent partial meniscectomy. Overall, 2 orthopaedic surgeons and 2 musculoskeletal radiologists independently and blindly reviewed the preoperative MRI scans for all 87 patients. For each meniscus tear, reviewers evaluated the following criteria: tear pattern, tear length, tear distance from the meniscocapsular junction, tear thickness, and integrity of any inner meniscal fragment. The resultant data were then applied to 5 different approaches for predicting meniscal reparability. Results: The accuracy for all examined prediction methods was poor, ranging from 55% (3-point method) to 72% (classification tree method) among all reviewers. Interobserver reliability for examined criteria was also poor, with kappa values ranging from 0.07 (inner meniscal fragment status) to 0.40 (tear pattern). Conclusion: MRI continues to be a poor predictor of meniscus tear reparability as assessed by arthroscopic criteria, even when using higher resolution 3-T scanners. Interobserver reliability in this setting can be poor, even among experienced clinicians.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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The Reliability of 3-T Magnetic Resonance Imaging to Identify Arthroscopic Features of Meniscal Tears and Its Utility to Predict Meniscal Tear Reparability

et al. 2021

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Post-operative Imaging: The Menisci

Magee

Rowbotham

2020

Postoperative Imaging of Sports Injuries

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Using only MRI is moderately reliable in the prediction of meniscal tear reparability

Mısır

Kızkapan²,

Yıldız

et al. 2018

Knee Surg Sports Traumatol Arthrosc

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Purpose The purpose of this study was to evaluate the role of surgeons’ experience with meniscal repairs and meniscectomy decisions, and to determine the factors affecting the disagreement between meniscal repairs and meniscectomy decisions. Methods In total, 223 patients with meniscal tears, 106 meniscal repairs, and 117 meniscectomies were included. Six orthopedic surgeons (3: > 5 years; 3: < 5 years’ arthroscopy experience) were blinded, and they independently reviewed all preoperative MR images for over a month. Their reviews were compared with arthroscopic interventions performed by a surgeon with > 10 years’ arthroscopy experience. Reparability‐associated factors were also evaluated using multivariate logistic regression. Results The first and second evaluation results did not differ significantly between groups (n.s.). There was good agreement between MRI predictions and arthroscopic interventions for both groups (< 5 years’ experience: k = 0.248, agreement 62.3%; > 5 years’ experience: k = 0.351, agreement 67.3%). Sex, side, and distance of tear from the meniscocapsular junction were not significantly different between agreements and disagreements. Disagreement regarding meniscectomy was significantly higher than those regarding meniscus repair (p = 0.002). Concomitant anterior cruciate ligament (ACL) injury, osteochondral lesions, and medial meniscal tear increased the likelihood of meniscal repair (p = 0.0063, p = 0.0010, and p = 0.0369, respectively). An increased risk of disagreement between MRI and surgical procedure was found in the presence of bucket‐handle, horizontal or complex tear, chronic tear, high sports activity and expectation level. Conclusion Surgeon's experience level may influence the prediction of meniscus reparability. Concomitant ACL injury, osteochondral lesions, and presence of medial meniscal tear increase the likelihood of meniscal repair. Tear type, tear chronicity, patient's activity and expectation level may influence the surgeon's operative decision in addition to MRI. Level of evidence III.

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Role of MRI in predicting meniscal tear reparability

Abstract: MRI can be a reliable and accurate tool to predict the reparability of meniscal tears, with higher prediction rates for bucket-handle tears.

Cited by 10 publications

References 20 publications

The Reliability of 3-T Magnetic Resonance Imaging to Identify Arthroscopic Features of Meniscal Tears and Its Utility to Predict Meniscal Tear Reparability

The Reliability of 3-T Magnetic Resonance Imaging to Identify Arthroscopic Features of Meniscal Tears and Its Utility to Predict Meniscal Tear Reparability

Post-operative Imaging: The Menisci

Using only MRI is moderately reliable in the prediction of meniscal tear reparability

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