The role of magnetic resonance imaging and clinical assessments in predicting meniscal tear surgery
Yaman Karakoç, İsmail Burak Atalay
Department of Orthopedics and Traumatology,
Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
Keywords: Arthroscopy, clinical examination, magnetic resonance imaging, meniscal tear, nonsurgical treatment.
Objectives: This study aims to investigate the role of physical examination and magnetic resonance imaging (MRI) findings in predicting meniscal tear surgery.
Patients and methods: Medical records of a total of 997 patients (563 females, 434 males; mean age 40.53 years; range 18 to 66 years) who were recommended surgery for meniscal tear in an external center, but continued follow-up in our hospital between January 2012 and March 2018 were retrospectively analyzed. Data of the patients including demographic and clinical characteristics, physical examination findings, and MRI results were recorded. The visual analog scales (VAS) scores and the Knee Injury and Osteoarthritis Outcome Score (KOOS) were evaluated.
Results: Of all the patients evaluated by MRI, 62.4% were recommended surgical treatment in private hospitals and 37.6% were recommended surgical intervention in state hospitals. Only 282 of them (28.3%) were treated surgically for meniscal tear after MRI evaluation and physical examination in our clinic. The median pre-treatment VAS score was 7.0 (range, 4 to 10) and 6.0 (range, 3 to 8) in the patients undergoing surgery and undergoing conservative treatment, respectively. The VAS and KOOS scores were similar between the groups at the postoperative sixth month and first year (p=0.940, p=0.203; p=116, p=0.057, respectively). Pain scores significantly decreased, while the KOOS scores significantly increased after the treatment in both groups (for all p=0.001).
Conclusion: Decision for surgery should be solely based on physical examination and radiological findings in meniscal tears