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MRI Predicts Repair of Meniscal Tears

How accurate are MRIs in predicting which meniscal tears can be repaired? Orthopedic surgeons at the University of Paris (France) compare arthroscopic results with prior MRI images to help answer this question.

This type of study uses the final diagnostic results from surgery to look back at MRI findings and see how accurate they were. Knowing what the surgeon found during the operation helps radiologists further refine what to look for on MRI images.

The goal is to recognize on the MRI meniscal tears that can be repaired. Specific MRI observations typical of a reparable lesion are described in detail. Only one type of meniscal tear was studied called a bucket handle meniscal tear (BHMT).

The meniscus is a horseshoe or C-shaped piece of cartilage. When the tear goes from top to bottom of the cartilage, the outer half of the torn meniscus can lift up. The motion resembles a bucket handle being lifted up and away from the rim of the bucket.

The results of this study show good agreement between MRI and arthroscopic findings. Only one case of a BHMT that could be repaired was missed on MRI. The authors say MRI is a good screening tool to identify reparable tears. The surgeon should be aware that new tears can occur after the MRI but before arthroscopic surgery.

References: Patricia Thoreux, MD, et al. Bucket-Handle Meniscal Lesions: Magnetic Resonance Imaging Criteria for Reparability. In Journal of Arthroscopy and Related Surgery. September 2006. Vol. 22. No. 9. Pp. 954-961.

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