Yusuke Hashimoto1, Kazuya Nishino2, Shinya Yamasaki3, Yohei Nishida2, Shinji Takahashi2, Hiroaki Nakamura2. 1. Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan. hussy@med.osaka-cu.ac.jp. 2. Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan. 3. Department of Orthopaedic Surgery, Osaka City General Hospital, 2-13-22 Miyakojima-hondori, Miyakojima-ku, Osaka, 534-0021, Japan.
Abstract
PURPOSE: To investigate the associations between the preoperative MRI findings suggestive of meniscal instability and the intraoperative finding of peripheral rim instability (PRI) in patients with complete discoid lateral meniscus (CDLM) of no-shift-type, which was identified as the peripheral portion was not separated from the capsule. METHODS: The records of 56 patients diagnosed with no-shift-type CDLM who underwent arthroscopic surgery were reviewed. We evaluated MRI findings of anterior parameniscal soft-tissue edema, linear fluid signal at the anterior meniscal margin, bulging of the meniscal margin, absence of popliteomeniscal fascicles, and hiatus widening on routine MRI. The positive predictive value (PPV), sensitivity, and specificity of these findings in predicting PRI were calculated; PRI was further investigated according to anterior and posterior location. RESULTS: Linear fluid signal at the anterior meniscal margin and bulging had high PPV and specificity (P = .004 and = .029, respectively) for overall of PRI. The presence of either anterior parameniscal soft-tissue edema or linear fluid signal at the anterior meniscal margin predicted anterior PRI with high PPV, sensitivity, and specificity. Bulging of the meniscal margin had high specificity, and either bulging of the meniscal margin or absence of popliteomeniscal fascicle had high sensitivity in predicting posterior PRI. CONCLUSIONS: A linear fluid signal at the anterior meniscus and anterior parameniscal soft-tissue edema were important signs of anterior PRI, whereas bulging of the margin had high specificity and either bulging of the meniscal margin or absence of popliteomeniscal fascicle had high sensitivity in detecting posterior PRI on routine MRI of no-shift-type CDLM. LEVEL OF EVIDENCE: Level IV therapeutic case series.
PURPOSE: To investigate the associations between the preoperative MRI findings suggestive of meniscal instability and the intraoperative finding of peripheral rim instability (PRI) in patients with complete discoid lateral meniscus (CDLM) of no-shift-type, which was identified as the peripheral portion was not separated from the capsule. METHODS: The records of 56 patients diagnosed with no-shift-type CDLM who underwent arthroscopic surgery were reviewed. We evaluated MRI findings of anterior parameniscal soft-tissue edema, linear fluid signal at the anterior meniscal margin, bulging of the meniscal margin, absence of popliteomeniscal fascicles, and hiatus widening on routine MRI. The positive predictive value (PPV), sensitivity, and specificity of these findings in predicting PRI were calculated; PRI was further investigated according to anterior and posterior location. RESULTS: Linear fluid signal at the anterior meniscal margin and bulging had high PPV and specificity (P = .004 and = .029, respectively) for overall of PRI. The presence of either anterior parameniscal soft-tissue edema or linear fluid signal at the anterior meniscal margin predicted anterior PRI with high PPV, sensitivity, and specificity. Bulging of the meniscal margin had high specificity, and either bulging of the meniscal margin or absence of popliteomeniscal fascicle had high sensitivity in predicting posterior PRI. CONCLUSIONS: A linear fluid signal at the anterior meniscus and anterior parameniscal soft-tissue edema were important signs of anterior PRI, whereas bulging of the margin had high specificity and either bulging of the meniscal margin or absence of popliteomeniscal fascicle had high sensitivity in detecting posterior PRI on routine MRI of no-shift-type CDLM. LEVEL OF EVIDENCE: Level IV therapeutic case series.
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