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Magnetic resonance imaging can increase the diagnostic accuracy in symptomatic meniscal repair patients

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of this study was to evaluate meniscal repair healing in symptomatic patients through combined clinical assessment, magnetic resonance imaging (MRI) and re-arthroscopy. This study investigated the diagnostic accuracy of MRI and clinical assessment in determining failed meniscal repair in symptomatic meniscal repair patients, as verified by re-arthroscopy.

Methods

Eighty patients were included. All had undergone a primary meniscal repair followed by an MRI and re-arthroscopy due to clinical symptoms of a meniscal lesion. A validated semi-quantitative scoring system was employed for identifying MRI-diagnosed healing failure. The clinical assessment was divided into joint swelling, joint-line tenderness, locking and a positive McMurray’s test. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of MRI and positive clinical findings were calculated using second-look arthroscopy as a standard.

Results

The MRI results showed healing of 22 (27.5%) of the menisci and 58 (72.5%) unhealed menisci, whereas second-look arthroscopy identified 15 (19%) healed menisci and 65 (81%) unhealed menisci. The isolated MRI findings were 0.85, 0.8, 0.95 and 0.55 for sensitivity, specificity, PPV and NPV, respectively. The PPVs of the clinical assessments were 0.78, 0.85 and 0.94, with one, two and three clinical findings, respectively. A grade 3 MRI combined with joint-line tenderness presented a PPV of 0.98.

Conclusion

A supplementary MRI will increase diagnostic accuracy when fewer than three clinical findings are present in a symptomatic meniscal repair patient. The clinical relevance of this finding is that MRI contributes to enhancing the diagnostic accuracy of an unhealed meniscal repair when there are limited clinical signs of meniscal pathology.

Level of evidence

III.

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Funding

There has been no funding of this study.

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Authors and Affiliations

  1. Department of Sports Traumatology, Aarhus University Hospital, Palle Juul-Jensens Blvd. 99, 8200, Aarhus N, Denmark

    Emilie Faunø, Ole Gade Sørensen, Torsten Grønbech Nielsen & Martin Lind

  2. Department of Radiology, Aarhus University Hospital, Palle Juul-Jensens Blvd. 99, 8200, Aarhus N, Denmark

    Claus Tvedesøe

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  1. Emilie Faunø
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  2. Ole Gade Sørensen
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Correspondence to Emilie Faunø.

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Conflict of interest

Emilie Faunø, Ole Gade Sørensen, Torsten Grønbech Nielsen, Martin Lind and Claus Tvedesøe declare that they have no conflict of interest.

Ethical approval

The project was approved by the Central Denmark Region Committees on Health Research Ethics (268/2017).

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Faunø, E., Sørensen, O.G., Nielsen, T.G. et al. Magnetic resonance imaging can increase the diagnostic accuracy in symptomatic meniscal repair patients. Knee Surg Sports Traumatol Arthrosc 28, 855–861 (2020). https://doi.org/10.1007/s00167-019-05523-1

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  • DOI: https://doi.org/10.1007/s00167-019-05523-1

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