Should We Prefer Magnetic Resonance Imaging to Physical Examination in Meniscal Tears

J Knee Surg DOI: 10.1055/s-0039-1693449The aim of this study was to compare the sensitivity, specificity, accuracy, positive and negative predictive values of magnetic resonance imaging (MRI), and clinical examination in the diagnosis of meniscus tears with the findings obtained from the knee joint arthroscopy. A retrospective study was made of 452 patients who underwent knee arthroscopy due to meniscus tears between 2012 and 2017. Physical examination was performed using the Thessaly's, McMurray's, and Joint line tenderness tests (JLTT). On preoperative MRI, medial meniscal tears were observed in 292 patients, lateral meniscal tears in 96 patients, and medial and lateral meniscal tears in 64 patients. According to the arthroscopy results, 284 patients had medial meniscal tears, 108 patients had lateral meniscal tears, and 60 patients had medial and lateral meniscal tears. Sensitivity and specificity of the JLTT was determined as 93 and 86% respectively for medial meniscal tears and 94 and 89% for lateral meniscal tears. The McMurray's test was 60% sensitive, 68% specific for medial meniscal tears (MMT), and 73% sensitive and 68% specific for lateral meniscus tears (LMT). The Thessaly's test was 93% sensitive and 87% specific for medial meniscal tears; and 94% sensitive and 88% specific for LMT. Compared with the arthroscopic findings, MRI was observed to have sensitivity of 94% for MMT and 84% for LMT. For specificity, the values were 89% for MMT and 91% for LMT. Accuracy wa...
Source: Journal of Knee Surgery - Category: Orthopaedics Authors: Tags: Original Article Source Type: research

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Fatty infiltration of the rotator cuff musculature increases in larger tears  and is a factor in retearing. However, tearing may recur even in patients with small original tears and little fatty infiltration of the rotator cuff musculature. We devised a system to classify the rotator cuff tendon stump by magnetic resonance imaging (MRI) signal intensity and investigated pr ognosis-related factors associated with retear based on other MRI findings.
Source: Journal of Shoulder and Elbow Surgery - Category: Orthopaedics Authors: Source Type: research
(American Orthopaedic Society for Sports Medicine) Using arthroscopy to stage a lesion in the chondral area of the knee is more accurate than magnetic resonance imaging, according to researchers from the Rothman Institute, La Jolla, Calif. The findings were presented today at the American Orthopedic Society of Sports Medicine Annual Meeting.
Source: EurekAlert! - Medicine and Health - Category: International Medicine & Public Health Source Type: news
This study compared the radiologic, arthroscopic, and clinical outcomes between repaired and unrepaired MMPHRT during OWHTO. Fifty-seven patients were prospectively enrolled from 2014 to 2016. The radiologic, arthroscopic, and clinical outcomes were compared between 25 patients who underwent OWHTO with all-inside repair of MMPRT using FasT-Fix (repaired group) and 32 patients who underwent OWHTO without repair of MMPRT (unrepaired group) with a mean 2-year follow up in both groups. The meniscal healing status was classified as complete, partial, or no healing, according to second-look arthroscopic findings. The medial meni...
Source: Journal of Knee Surgery - Category: Orthopaedics Authors: Tags: Original Article Source Type: research
We report a case of massive primary SC of the knee, properly evaluated with X-rays, ultrasonography and magnetic resonance imaging and successfully treated with an arthroscopic approach. PMID: 31309778 [PubMed - in process]
Source: Reumatismo - Category: Rheumatology Authors: Tags: Reumatismo Source Type: research
The objective of this study was to determine the effects of body mass index (BMI), as a modifiable risk factor, on meniscal, chondral, and ligamentous injuries, as well as on bone marrow edema accompanying anterior cruciate ligament (ACL) rupture. This retrospective observational study analyzed 84 male patients who underwent primary ACL reconstruction from 2015 to 2018. Magnetic resonance imaging was performed within 6 weeks of injury. Bone bruise, tendon, ligament, meniscal, and muscle injuries were evaluated. The surgery was performed within 3 months after the injury. Detailed arthroscopic findings (chondral, meniscal, a...
Source: Journal of Knee Surgery - Category: Orthopaedics Authors: Tags: Original Article Source Type: research
Publication date: Available online 4 July 2019Source: Arthroscopy TechniquesAuthor(s): Ashley J. Bassett, Christopher J. Hadley, Fotios Tjoumakaris, Kevin B. FreedmanAbstractVertical flap tears, or parrot beak flap tears, are oblique tears of the meniscus thought to originate as a central radial tear and propagate longitudinally towards the periphery, generating a partially detached unstable fragment that can subsequently displace into the meniscal recess. Although magnetic resonance imaging (MRI) is frequently used to diagnose and characterize meniscus pathology, imaging findings for displaced flap tears are not well desc...
Source: Arthroscopy Techniques - Category: Surgery Source Type: research
ConclusionZoledronic acid appeared to be more effective than other antiresorptive medications —at the cost of more frequent adverse events. While radiological and laboratory evaluation methods may allow for objective treatment monitoring, they appear to capture different dimensions than patient-reported pain.Level of evidenceIII.
Source: Knee Surgery, Sports Traumatology, Arthroscopy - Category: Orthopaedics Source Type: research
CONCLUSION: Prompt and accurate diagnosis of surgical site infection following ACL reconstruction, including the exclusion of intra-articular involvement, is important for timely and appropriate treatment. Arthroscopic debridement and removal of implant with graft preservation, together with a course of antibiotics, is a suitable treatment option for extra-articular knee infections following ACL reconstruction. PMID: 31259149 [PubMed]
Source: World Journal of Orthopaedics - Category: Orthopaedics Tags: World J Orthop Source Type: research
CONCLUSION: Arthroscopic remplissage of a shoulder Hill-Sachs lesion with high-strength sutures carries the benefits of secure fixing and good tendon-bone healing without the risk of anchor detachment. PMID: 31270558 [PubMed - as supplied by publisher]
Source: Der Orthopade - Category: Orthopaedics Authors: Tags: Orthopade Source Type: research
ConclusionsAlthough previous results showed more outliers regarding posterior slope for CT-based PSIs, no difference in revision rate or the outcome of PROMs was found at 2-year follow-up. Further research to determine what the influence is of radiological outliers on implant survival and clinical outcomes is necessary.Level of evidenceI.
Source: Knee Surgery, Sports Traumatology, Arthroscopy - Category: Orthopaedics Source Type: research
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