Vinay Kumaraswamy1, Arun G Ramaswamy2, Shyam Sundar3, David V Rajan3, Karthik Selvaraj3, Santosh Sahanand3, S Deebak4. 1. Department of Orthopaedics, Bangalore Medical College and Research Institute, Bangalore, India. maildrvinay@gmail.com. 2. Department of Orthopaedics, Mysore Medical College, Mysore, India. 3. Ortho One, Orthopaedic Specialty Hospital, 657, Trichy Road, Singanallur, Coimbatore, Tamil Nadu, 641005, India. 4. OrthoDent, Shenoy Nagar, Chennai, India.
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.
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.
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Authors: Betina B Hinckel; Charles A Baumann; Leandro Ejnisman; Leonardo M Cavinatto; Alexander Martusiewicz; Miho J Tanaka; Marc Tompkins; Seth L Sherman; Jorge A Chahla; Rachel Frank; Guilherme L Yamamoto; James Bicos; Liza Arendt; Donald Fithian; Jack Farr Journal: J Am Acad Orthop Surg Glob Res Rev Date: 2020-10-01