Skip to main content
Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 11/2019

08.02.2019 | KNEE

A new scoring system for prediction of meniscal repair in traumatic meniscal tears

verfasst von: Vinay Kumaraswamy, Arun G. Ramaswamy, Shyam Sundar, David V. Rajan, Karthik Selvaraj, Santosh Sahanand, S. Deebak

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 11/2019

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Traditionally, MRI has not been used to predict meniscus tear reparability. An attempt has been made in this study to predict meniscal reparability using MRI, and a new scoring system to help with the same has been developed and tested.

Methods

Thirty repaired menisci were compared with equal number of meniscectomy cases retrospectively. Various clinical and radiological (radiographs and MRI) characteristics like chronicity of tear, pattern of tear, etc, were tabulated. Based on their association with the outcome of repair or meniscectomy, odds ratio of each attribute were calculated. A scoring system—Ortho One PROMT Score (Prediction of Reparability of Meniscal Tears)—to predict meniscal repair was formulated. Using this score, meniscus surgery outcomes were prospectively predicted in 120 cases and results tabulated.

Results

The newly devised Ortho One PROMT score predicted medial meniscus repair with a sensitivity of 90.9% and a specificity of 93.2% and medial meniscectomy with a sensitivity of 93.2% and a specificity of 90.9%. It predicts lateral meniscus repair with a sensitivity of 69.2% of patients and lateral meniscectomy with a sensitivity of 78.8% of patients.

Conclusion

Ortho One PROMT score is a useful scoring system to predict the outcomes of meniscus surgery preoperatively. It uses a combination of clinical and radiological (MRI and plain radiograph) characteristics. With this scoring system, both the surgeon and the patient are better prepared preoperatively regarding the outcome of a particular meniscus surgery. The scoring shall make day-to-day arthroscopic meniscus surgery less stressful.

Level of evidence

III.
Literatur
1.
Zurück zum Zitat Bernthal NM, Seeger LL, Motamedi K, Stavrakis AI, Kremen TJ, McAllister DR et al (2011) Can the reparability of meniscal tears be predicted with magnetic resonance imaging? Am J Sports Med 39:506–510CrossRef Bernthal NM, Seeger LL, Motamedi K, Stavrakis AI, Kremen TJ, McAllister DR et al (2011) Can the reparability of meniscal tears be predicted with magnetic resonance imaging? Am J Sports Med 39:506–510CrossRef
2.
Zurück zum Zitat Bowers ME, Tung GA, Oksendahl HL, Hulstyn MJ, Fadale PD, Machan JT et al (2010) Quantitative magnetic resonance imaging detects changes in meniscal volume in vivo after partial meniscectomy. Am J Sports Med 38:1631–1637CrossRef Bowers ME, Tung GA, Oksendahl HL, Hulstyn MJ, Fadale PD, Machan JT et al (2010) Quantitative magnetic resonance imaging detects changes in meniscal volume in vivo after partial meniscectomy. Am J Sports Med 38:1631–1637CrossRef
3.
Zurück zum Zitat Catherine Laible MD, Drew A, Stein MD, Daniel N, Kiridly (2013) Meniscal repair. J Am Acad Orthop Surg 21:204–213CrossRef Catherine Laible MD, Drew A, Stein MD, Daniel N, Kiridly (2013) Meniscal repair. J Am Acad Orthop Surg 21:204–213CrossRef
4.
Zurück zum Zitat Hoffelner T, Resch H, Forstner R, Michael M, Minnich B, Tauber M (2011) 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. Skelet Radiol 40:181–187CrossRef Hoffelner T, Resch H, Forstner R, Michael M, Minnich B, Tauber M (2011) 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. Skelet Radiol 40:181–187CrossRef
5.
Zurück zum Zitat Hulley SB, Cummings SR, Browner WS, Grady D, Newman TB (2013) Designing clinical research: an epidemiologic approach, 4th edn. Lippincott Williams & Wilkins, Philadelphia, p 79 (appendix 6C) Hulley SB, Cummings SR, Browner WS, Grady D, Newman TB (2013) Designing clinical research: an epidemiologic approach, 4th edn. Lippincott Williams & Wilkins, Philadelphia, p 79 (appendix 6C)
6.
Zurück zum Zitat Konan S, Haddad FS (2010) Outcomes of meniscal preservation using all-inside meniscus repair devices. Clin Orthop Relat Res 468:1209–1213CrossRef Konan S, Haddad FS (2010) Outcomes of meniscal preservation using all-inside meniscus repair devices. Clin Orthop Relat Res 468:1209–1213CrossRef
7.
Zurück zum Zitat Kuikka PI, Sillanpää P, Mattila VM, Niva MH, Pihlajamäki HK (2009) Magnetic resonance imaging in acute traumatic and chronic meniscal tears of the knee: a diagnostic accuracy study in young adults. Am J Sports Med 37:1003–1008CrossRef Kuikka PI, Sillanpää P, Mattila VM, Niva MH, Pihlajamäki HK (2009) Magnetic resonance imaging in acute traumatic and chronic meniscal tears of the knee: a diagnostic accuracy study in young adults. Am J Sports Med 37:1003–1008CrossRef
8.
Zurück zum Zitat Majewski M, Stoll R, Widmer H, Müller W, Friederich NF (2006) Midterm and long-term results after arthroscopic suture repair of isolated, longitudinal, vertical meniscal tears in stable knees. Am J Sports Med 34:1072–1076CrossRef Majewski M, Stoll R, Widmer H, Müller W, Friederich NF (2006) Midterm and long-term results after arthroscopic suture repair of isolated, longitudinal, vertical meniscal tears in stable knees. Am J Sports Med 34:1072–1076CrossRef
9.
Zurück zum Zitat Marzo JM, Gurske-DePerio J (2009) Effects of medial meniscus posterior horn avulsion and repair on tibiofemoral contact area and peak contact pressure with clinical implications. Am J Sports Med 37:124–129CrossRef Marzo JM, Gurske-DePerio J (2009) Effects of medial meniscus posterior horn avulsion and repair on tibiofemoral contact area and peak contact pressure with clinical implications. Am J Sports Med 37:124–129CrossRef
10.
Zurück zum Zitat Matava M, Eck K, Totty W, Wright R, Shively R (1999) Magnetic resonance imaging as a tool to predict meniscal reparability. Am J Sports Med 27:436–443CrossRef Matava M, Eck K, Totty W, Wright R, Shively R (1999) Magnetic resonance imaging as a tool to predict meniscal reparability. Am J Sports Med 27:436–443CrossRef
11.
Zurück zum Zitat Nemec SF, Marlovits S, Trattnig S, Matzek W, Mayerhoefer ME, Krestan CR (2008) High-resolution magnetic resonance imaging and conventional magnetic resonance imaging on a standard field-strength magnetic resonance system compared to arthroscopy in patients with suspected meniscal tears. Acad Radiol 15(7):928–933CrossRef Nemec SF, Marlovits S, Trattnig S, Matzek W, Mayerhoefer ME, Krestan CR (2008) High-resolution magnetic resonance imaging and conventional magnetic resonance imaging on a standard field-strength magnetic resonance system compared to arthroscopy in patients with suspected meniscal tears. Acad Radiol 15(7):928–933CrossRef
12.
Zurück zum Zitat Júnior N, Leão M, Oliveira N (2015) Diagnosis of knee injuries: comparison of the physical examination and magnetic resonance imaging with the findings from arthroscopy. Rev Bras Ortop 50(6):712–719CrossRef Júnior N, Leão M, Oliveira N (2015) Diagnosis of knee injuries: comparison of the physical examination and magnetic resonance imaging with the findings from arthroscopy. Rev Bras Ortop 50(6):712–719CrossRef
13.
Zurück zum Zitat Nourissat G, Beaufils P, Charrois O, Selmi TA, Thoreux P, Moyen B et al (2008) Magnetic resonance imaging as a tool to predict reparability of longitudinal full-thickness meniscus lesions. Knee Surg Sports Traumatol Arthrosc 16:482–486CrossRef Nourissat G, Beaufils P, Charrois O, Selmi TA, Thoreux P, Moyen B et al (2008) Magnetic resonance imaging as a tool to predict reparability of longitudinal full-thickness meniscus lesions. Knee Surg Sports Traumatol Arthrosc 16:482–486CrossRef
14.
Zurück zum Zitat Pujol N, Tardy N, Boisrenoult P, Beaufils P (2013) Magnetic Resonance Imaging is not suitable for interpretation of meniscal status ten years after arthroscopic repair. Int Orthop 37:2371–2376CrossRef Pujol N, Tardy N, Boisrenoult P, Beaufils P (2013) Magnetic Resonance Imaging is not suitable for interpretation of meniscal status ten years after arthroscopic repair. Int Orthop 37:2371–2376CrossRef
Metadaten
Titel
A new scoring system for prediction of meniscal repair in traumatic meniscal tears
verfasst von
Vinay Kumaraswamy
Arun G. Ramaswamy
Shyam Sundar
David V. Rajan
Karthik Selvaraj
Santosh Sahanand
S. Deebak
Publikationsdatum
08.02.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 11/2019
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-019-05377-7

Weitere Artikel der Ausgabe 11/2019

Knee Surgery, Sports Traumatology, Arthroscopy 11/2019 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.