📇 Rhumatologue · GONESSE CEDEX · (95) · Salarié
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CH GENERAL DE GONESSE
2 BD DU 19 MARS 1962 CS 30071, 95503 GONESSE CEDEX
CENTRE D IMAGERIE MEDICALE LS
CENTRE DE RADIOLOGIE 25 RUE DU DOCTEUR PAUL BRUEL, 95380 LOUVRES
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CENTRE D IMAGERIE MEDICALE LS
SELARL CENTRE D IMAGERIE MEDICALE L.S., 60520 LA CHAPELLE EN SERVAL
GIE IRM DE SENLIS
CENTRE HOSPITALIER DE SENLIS 28 AV PAUL ROUGÉ, 60300 SENLIS
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Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association · 2006
Purpose The purpose of this study was to determine the accuracy of magnetic resonance imaging (MRI) in predicting knee bucket‐handle meniscal tear (BHMT) reparability. Methods Twenty‐eight patients who underwent knee arthroscopy by a single surgeon for BHMT with prior MRI examination were included. BHMTs were diagnosed by MRI based on the association of a displaced meniscal fragment on coronal images and one of the following three signs on sagittal slices: flipped meniscus sign, double posterior cruciate ligament, and meniscal fragment within the intercondylar notch. BHMT patients’ MRIs were retrospectively reviewed independently to search for criteria of reparability by 2 observers with different degrees of experience in musculoskeletal radiology, and disagreements were arbitrated to consensus. The criteria for BHMT reparability were as follows: (1) rim width of less than 4 mm; (2) tear length of 1 cm or greater, regardless of total lesion length; and (3) generation of isosignals by the inner meniscal fragment and peripheral rim compared with the normal contralateral meniscus of the same knee. The first 2 criteria indicate an adequate meniscal lesion length in the vascularized zone (only the peripheral third), enabling meniscal healing after repair; the third criterion guarantees that the meniscus is nondegenerative. Results Of the BHMTs, 5 (17.9%) were arthroscopically reparable and 23 (82.1%) were not. Interpretation of magnetic resonance images correctly predicted reparability in 4 of 5 reparable BHMTs and irreparability in 22 of 23 irreparable BHMTs (26/28 lesions). Interobserver agreement was good for the prediction of reparability (κ = 0.7). Conclusions These results suggest that knee BHMTs that are predicted to be reparable by MRI would have a high likelihood of actually being reparable. Level of Evidence Level II, development of diagnostic criteria on basis of consecutive patients and gold standard.
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Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association · 2006 · Journal Article
Thoreux P, Réty F, Nourissat G, Rivière X, et al.