The role of magnetic resonance imaging in routine decision making for meniscal surgery.
This clinical study evaluated factors affecting the decision for meniscal surgery in a patient population seen routinely at a trauma clinic. The study hypothesis was that patients who sustain a traumatic injury to the knee or have a long history of clinical symptoms are likelier to be operated on. We investigated 149 patients clinically and by magnetic resonance imaging (MRI). Group A (n = 62) underwent arthroscopic surgery and group B (n = 87) were treated conservatively. Multiple logistic regression analysis was used to examine correlations with regard to age, gender, injury pattern, period between the injury and first clinical examination, and MRI results. We found no significant difference between the two groups with regard to gender (P = 0.1), injury pattern (P = 0.44), or period between injury and first clinical examination (P = 0.5). Patients in group A were significantly older than those in group B (P = 0.044), and, as expected, MRI signal alterations were significantly higher in group A than in group B (P = 0.001). In acutely injured patients MRI helps to establish an accurate diagnosis, and in cases of positive MRI findings in a symptomatic patient, the surgeon should not wait 4-6 weeks but should immediately recommend surgery.
Muellner
T
T
University Clinic of Traumatology, University of Vienna Medical School, Währinger Gürtel 18-20, A-1090 Vienna, Austria. tmuellner@csi.com
Nikolic
A
A
Kubiena
H
H
Kainberger
F
F
Mittlboeck
M
M
Vécsei
V
V
D000208:Acute Disease; D000328:Adult; D000367:Age Factors; D001182:Arthroscopy; D003657:Decision Making; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000601:surgery; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery*; D012737:Sex Factors; D000070600:Tibial Meniscus Injuries; D013997:Time Factors