Introduction of an MR-based semi-quantitative score for assessing partial meniscectomy and relation to knee joint degenerative disease: data from the Osteoarthritis Initiative
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Dong Sun1,2, Jan Neumann1, Gabby B Joseph1
1Musculoskeletal and Quantitative Imaging Research Group, Department of Radiology & Biomedical Imaging, University of California San Francisco, 185 Berry St, Suite 350, San Francisco, CA, 94107, USA.
Objectives:
To develop an MR-based semi-quantitative meniscus scoring technique for postoperative assessment of the degree of meniscal resection, to test its reproducibility, and to study the relationship between the amount of resection and degenerative disease burden.
Methods:
We studied the right knee of 135 participants from the Osteoarthritis Initiative that underwent meniscal surgery an average of 14 years previously. The amount of meniscal resection was assessed on baseline 3.0-T MRIs and calculated as meniscus resection score (MenRS) with a range of 0 to 18. Knee abnormalities at baseline and 48 months were graded using a modified Whole-Organ Magnetic Resonance Imaging Score (WORMS). Subjects were also stratified according to meniscal resection performed after injury versus without preceding injury. Statistical analysis included intra-class correlation coefficient (ICC) to determine reproducibility as well as regression models and partial correlations to correlate MenRS with WORMS outcomes.
Results:
ICC values for intra- and inter-observer reproducibility of MenRS were 0.980 and 0.977, respectively. Overall, the amount of meniscal resection showed a significant correlation with baseline WORMS grades: higher MenRS was associated with higher total WORMS grades (p = 0.004) and cartilage (p = 0.004) and ligament (p < 0.001) subscores. However, no significant association between MenRS and change in WORMS grades over 48 months was found. The relationship between MenRS and baseline WORMS grades did not change after adjusting for a reported history of knee injury.
Conclusions:
Postoperative assessment of the knee following partial meniscectomy using the newly developed MenRS showed excellent reproducibility and significant cross-sectional correlation with WORMS gradings.
Key Points:
• The newly developed semi-quantitative MR-based meniscal resection score demonstrated excellent reproducibility. • A significant correlation between the amount of meniscal resection measured using the newly developed score and the degree of overall knee joint degenerative disease and cartilage defects was found.
Insights
A new MRI scoring technique (MenRS) reliably assesses meniscus surgery outcomes. Higher scores correlate with greater knee degeneration and cartilage damage post-surgery.
Area of Science:
- Orthopedic Surgery
- Radiology
- Biomedical Engineering
Background:
- Partial meniscectomy is a common orthopedic procedure.
- Assessing the extent of meniscal resection and its long-term impact is crucial for patient outcomes.
- Current methods for evaluating meniscal resection may lack precision or reproducibility.
Purpose of the Study:
- To develop and validate a semi-quantitative, MRI-based scoring technique for assessing meniscal resection.
- To evaluate the reproducibility of this novel scoring method.
- To investigate the association between the degree of meniscal resection and the burden of degenerative knee disease.
Main Methods:
- A cohort of 135 participants from the Osteoarthritis Initiative with prior meniscal surgery were analyzed.
- A meniscus resection score (MenRS) was developed using baseline 3.0-T MRIs.
- Knee abnormalities were graded using the Whole-Organ Magnetic Resonance Imaging Score (WORMS) at baseline and 48 months.
Main Results:
- The MenRS demonstrated excellent intra- and inter-observer reproducibility (ICC > 0.97).
- Higher MenRS values significantly correlated with greater baseline total WORMS scores, as well as cartilage and ligament subscores.
- No significant association was found between MenRS and the change in WORMS grades over 48 months.
Conclusions:
- The developed MenRS is a reproducible tool for assessing meniscal resection post-surgery.
- The amount of meniscal tissue removed, as quantified by MenRS, is significantly associated with the degree of baseline knee joint degeneration.
- This scoring technique aids in understanding the relationship between surgical intervention and degenerative disease progression.
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