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

Abdulhamit Misir1, Turan Bilge Kizkapan2, Kadir Ilker Yildiz3

  • 1Şanlıurfa Eğitim ve Araştırma Hastanesi, Ortopedi ve Travmatoloji Bölümü, Akpıyar mah. 4061. Sk. Yaşamkent Park evleri no: 29 B blok d: 21 Karaköprü, Şanlıurfa, Turkey. misirabdulhamitmd@gmail.com.

Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA
|October 1, 2018
PubMed
Abstract

Insights

Surgeon experience impacts meniscus tear treatment decisions, with higher disagreement rates for meniscectomy versus repair. Factors like ACL injury and tear type influence surgical choices beyond MRI.

Area of Science:

  • Orthopedic surgery
  • Knee arthroscopy
  • Meniscal tear management

Background:

  • Meniscal tears are common knee injuries requiring surgical decisions between repair and meniscectomy.
  • Surgeon experience and preoperative imaging influence these treatment choices.
  • Understanding factors affecting decision disagreement is crucial for optimizing patient outcomes.

Purpose of the Study:

  • To evaluate the impact of orthopedic surgeons' experience on meniscal repair versus meniscectomy decisions.
  • To identify factors contributing to disagreements between predicted and actual arthroscopic interventions for meniscal tears.

Main Methods:

  • 223 patients with meniscal tears were reviewed by six surgeons with varying arthroscopy experience (>5 years vs. <5 years).
  • Surgeons' preoperative MRI interpretations were compared against actual arthroscopic interventions.
  • Multivariate logistic regression analyzed factors influencing repairability and decision disagreement.

Main Results:

  • Agreement between MRI predictions and arthroscopic interventions showed moderate levels for both experienced (67.3%) and less experienced (62.3%) surgeons.
  • Disagreement was significantly higher for meniscectomy decisions compared to meniscus repair decisions (p=0.002).
  • Concomitant anterior cruciate ligament (ACL) injury, osteochondral lesions, and medial meniscal tears increased the likelihood of repair (p<0.05).

Conclusions:

  • Surgeon experience may influence the prediction of meniscus reparability.
  • Anterior cruciate ligament (ACL) injury, osteochondral lesions, and medial meniscal tears favor meniscal repair.
  • Tear characteristics, chronicity, and patient factors significantly impact surgical decisions beyond MRI findings.
Keywords:
Concomitant lesionDisagreementExperienceMeniscal repairMeniscectomyReparabilitySurgeon

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