2023 ISAKOS Biennial Congress ePoster
Accuracy of Magnetic Resonance Imaging for Detecting Meniscal Tears in Anterior Cruciate Ligament injuries.
Artit Boonrod, MD, Khon Kaen, Khon Kaen THAILAND
Watcharapong Wongsawiang , MD, Khon Kaen THAILAND
Punthip Thammaroj , MD, Khon Kaen THAILAND
Sermsak Sumanont, Khon Kaen THAILAND
Punyawat Apiwatanakul, MD, Mueang, Khon Kaen THAILAND
Arunnit Boonrod, MD, Khon Kaen THAILAND
Khon Kaen University, Khon Kaen, THAILAND
FDA Status Cleared
Summary
The accuracy of tear detection by MRI were 71.3% for the medial meniscus tear and 72.0% for the lateral meniscus tear. MRI has a fair to moderate agreement between intraoperative and radiologists' consensus to identify the tear and location of the meniscus in patients with ACL injuries. For medial and lateral meniscus tear, bucket handle tear had the highest accuracy.
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Abstract
Background
Preoperative MRI has limitations in detecting certain types and locations of meniscal tears. For patients with significant ACL injuries when the operation is needed, pre-operative MRI is not always performed. Hence the accuracy of MRI to detect meniscal tears is not well investigated in this group of patients. This study aims to evaluate the accuracy of MRI in detecting specific types and location of meniscal tears in patients with ACL injury planning for arthroscopic knee surgery.
Method
The authors retrospectively analyzed the patients' records of anterior cruciate ligament knee injuries from 2010 to 2019. All MRIs were re-evaluated by two radiologists who were blinded to the clinical history and arthroscopic findings. The type and location of meniscal tear were recorded for MRI and arthroscopic findings.
Study design: Retrospective study (Diagnosis); Level of evidence, 3.
Results
There were 614 patients with anterior cruciate ligament knee injuries. After exclusion, 143 patients were included. The sensitivity, specificity, and accuracy of tear detection by MRI were 86.4%. 51.6% and 71.3% for the medial meniscus tear and 88.4%, 56.8%, and 72.0% for the lateral meniscus tear. MRI showed a significant moderate agreement for the detection of both medial and lateral meniscus (0.395 and 0.446, p-value <0.001). The timing of the scan does not significantly affect the accuracy of detecting meniscal tears (p-value = 0.087-0.641). MRI had a significant fair agreement to locate the tear in both medial and lateral meniscus (0.221 and 0.380, p-value <0.001). For medial and lateral meniscus tear, bucket handle tear had the highest accuracy (92.3% and 97.2%, p-value<0.001). Interobservers' reliability showed a significantly good agreement for detecting the tear and location in the medial and lateral meniscus.
Conclusion
MRI has a fair to moderate agreement between intraoperative and radiologists' consensus to identify the tear and location of the meniscus in patients with ACL injuries. Timing is not correlated with accuracy; therefore, repeated MRI is not needed if there is no new trauma event.