Evaluation of the Relationship Between Clinical Findings and Magnetic Resonance Imaging Findings of Patients with Arthroscopic Meniscus Repair

Objective: In this study, the relationship between clinical findings and magnetic resonance imaging (MRI) findings in patients undergoing arthroscopic meniscus repair was investigated.Methods: Seventy patients with a mean age of 29.3 ± 9.2 (range; 18-54) were included in the study. The clinical evaluation of the meniscus repairs was made according to the criteria described by Barret. MRI results were evaluated according to the classification made by Crues et al. In addition, the clinical healing and satisfaction of the patients were evaluated with preoperative and postoperative the Lysholm functional scoring. Both clinical and MRI results were compared based on age, time to surgery, type of tear, localization of the ruptured meniscus, combination with anterior cruciate ligament reconstruction.Results: While the results of 58 (83%) patients were successful in the clinical evaluation, the number of cases that recovered according to the MRI results was found to be 39 (55.7%). The mean Lysholm functional score, which was 62.64±19.73 preoperatively, increased to 90.93±9.58 at the final follow-up. Consistency between improvement in MRI according to Kappa analysis and success or failure according to clinical evaluation was found to be insignificant. In this analysis, the sensitivity coefficient was 52.86% and the Kappa value was calculated as 0.123.Conclusion: No correlation was found between clinical evaluation and MRI results in the statistical analysis. According to the results of this study, clinical evaluation and Lysholm functional scoring help the clinician more in case follow-up and the success of the surgery compared to the MRI results.

Keywords:

Meniscus repair, Lysholm Barret criteria, magnetic resonance,

PDF

___

References 1. Englund M, Roemer F, Hayashi D. Meniscus pathology, osteoarthritis, and the treatment controversy. Nat Rev Rheumatol. 2012; 8: 412–419.
2. Kılıç B. Six-year follow-up after arthroscopic meniscectomy. Adv Environ Biol. 2015; 9: 50–3.
3. Indelli P, Szivek J, Schnepp A. Load Bearing at the Meniscofemoral Joint. Duke Orthop J. 2010 July; 1: 39-43.
4. Bernard CD, Kennedy NI, Tagliero AJ, Camp CL, Saris DBF, Levy BA. et al. Medial Meniscus Posterior Root Tear Treatment: A Matched Cohort Comparison of Nonoperative Management, Partial Meniscectomy, and Repair. The American Journal of Sports Medicine. 2020; 48: 128-132.
5. Brian FT. MD, Brian LC. Biomechanics and Clinical Outcomes of Partial Meniscectomy, Journal of the American Academy of Orthopaedic Surgeons: 2018; 26: 853-863.
6. Hoffelner T, Resch H, Forstner R,Michael M, Minnich B. Arthroscopic all-inside meniscal repair—Does the meniscus heal? A clinical and radiological follow-up examination to verify meniscal healing using a 3-T MRI. Skeletal Radiol.2011; 40: 181–187.
7. Muellner T, Egkher A, Nikolic A, Funovics M, Metz V. Open meniscal repair: clinical and magnetic resonance imaging findings after twelve years. Am J Sports Med 1999; 27: 16-20. 8. Hantes ME, Zachos VC, Zibis AH, Papanagiotou P, Karahalios T, Malizos KN. Evaluation of meniscal repair with serial magnetic resonance imaging: A comparative study between conventional MRI and indirect MR arthrography. Eur J Radiol. 2004; 50: 231–237.
9. Yu M, Yu JK, Ao YF, Zheng ZZ, Gong X, Leung KKM. Diagnostic values of 3 methods for evaluating meniscal healing status after meniscal repair: Comparison among second-look arthroscopy, clinical assessment, and magnetic resonance imaging. Am J Sports Med. 2011; 39: 735-42.
10. Barrett GR, Field MH, Treacy SH, Ruff CG. Clinical results of meniscus repair in patients 40 years and older. Arthroscopy. 1998;14: 824–9.
11. Crues JV, Mink J, Levy TL, Lotysch M, Stoller DW. Meniscal tears of the knee: accuracy of MR imaging. Radiology 1987; 164: 445-448.
12. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977; 33: 159-174.
13. Stone RG, Frewin PR, Gonzales S. Long-term assessment of arthroscopic meniscus repair: A two- to six-year follow-up study. Arthrosc J Arthrosc Relat Surg. 1990; 6: 73–8.
14. Steenbrugge F, Verdonk R, Verstraete K. Long-term assessment of arthroscopic meniscus repair: A 13-year follow-up study. Knee. 2002;9: 181–7.
15. Steadman JR, Matheny LM, Singleton SB, Johnson NS, Rodkey WG, Crespo B. Meniscus Suture Repair: Minimum 10-Year Outcomes in Patients Younger Than 40 Years Compared with Patients 40 and Older. Am J Sports Med. 2015; 43: 2222–7.
16. Morgan CD, Wojtys EM, Casscells CD, Casscells SW. Arthroscopic meniscal repair evaluated by second-look arthroscopy. The American Journal of Sports Medicine. 1991; 19: 632-638.
17. Fok AWM, Yau WP. Early results of all-inside meniscal repairs using a pre-loaded suture anchor. Hong Kong Med J. 2013; 19: 124–8.
18. Lysholm J, Gillquist J. Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale. Am J Sports Med. 1982; 10: 150–4.
19. Feng H, Hong L, Geng XS, Zhang H, Wang XS, Jiang XY: Second-look arthroscopic evaluation of bucket-handle meniscus tear repairs with anterior cruciate ligament reconstruction: 67 consecutive cases. Arthroscopy. 2008; 24: 1358-66.
20. Patil AS, Chandorkar AH. Imaging of Meniscus Repair and Healing: A Review of Current Trends/ Literature. Asian Journal of Arthroscopy 2016; 1: 23-27.
21. Miao Y, Yu JK, Zheng ZZ, Yu CL, Ao YF, Gong X. MRI signal changes in completely healed meniscus confirmed by second-look arthroscopy after meniscal repair with bioabsorbable arrows. Knee Surgery, Sport Traumatol Arthrosc. 2009; 17: 622–30.
22. Henning CE, Lynch MA, Yearout KM, Vequist SW, Stallbaumer RJ, Decker KA. Arthroscopic meniscal repair using an exogenous fibrin clot. Clinical Orthopaedics and Related Research. 1990; 252: 64-72.
23. Vance K, Meredick R, Schweitzer ME, Lubowitz JH. Magnetic Resonance Imaging of the Postoperative Meniscus. Arthroscopy. 2009; 25: 522-30
24. Eggli S, Wegmüller H, Kosina J, Huckell C, Jakob RP. Long-term Results of Arthroscopic Meniscal Repair: An Analysis of Isolated Tears. Am J Sports Med. 1995; 23: 715–20.

Middle Black Sea Journal of Health Science-Cover

Yayın Aralığı: Yılda 4 Sayı
Başlangıç: 2015
Yayıncı: Ordu Üniversitesi

Arşiv