A new scoring system for prediction of meniscal repair in traumatic meniscal tears
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A new scoring system for prediction of meniscal repair in traumatic meniscal tears Vinay Kumaraswamy1 · Arun G. Ramaswamy2 · Shyam Sundar3 · David V. Rajan3 · Karthik Selvaraj3 · Santosh Sahanand3 · S. Deebak4 Received: 3 July 2018 / Accepted: 24 January 2019 © European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2019
Abstract Purpose Traditionally, MRI has not been used to predict meniscus tear reparability. An attempt has been made in this study to predict meniscal reparability using MRI, and a new scoring system to help with the same has been developed and tested. Methods Thirty repaired menisci were compared with equal number of meniscectomy cases retrospectively. Various clinical and radiological (radiographs and MRI) characteristics like chronicity of tear, pattern of tear, etc, were tabulated. Based on their association with the outcome of repair or meniscectomy, odds ratio of each attribute were calculated. A scoring system—Ortho One PROMT Score (Prediction of Reparability of Meniscal Tears)—to predict meniscal repair was formulated. Using this score, meniscus surgery outcomes were prospectively predicted in 120 cases and results tabulated. Results The newly devised Ortho One PROMT score predicted medial meniscus repair with a sensitivity of 90.9% and a specificity of 93.2% and medial meniscectomy with a sensitivity of 93.2% and a specificity of 90.9%. It predicts lateral meniscus repair with a sensitivity of 69.2% of patients and lateral meniscectomy with a sensitivity of 78.8% of patients. Conclusion Ortho One PROMT score is a useful scoring system to predict the outcomes of meniscus surgery preoperatively. It uses a combination of clinical and radiological (MRI and plain radiograph) characteristics. With this scoring system, both the surgeon and the patient are better prepared preoperatively regarding the outcome of a particular meniscus surgery. The scoring shall make day-to-day arthroscopic meniscus surgery less stressful. Level of evidence III. Keywords Meniscus repair · Meniscectomy · Scoring · Prediction Abbreviations PROMT Prediction of Reparability of Meniscus Tears BHMT Bucket handle meniscus tear MRI Magnetic resonance imaging
Introduction Meniscal repair and meniscectomy (partial or total) are most commonly performed arthroscopic surgeries for meniscal tears [1, 2]. However, the cost, surgical time, expertise needed during surgery and the results are
* Vinay Kumaraswamy [email protected]
S. Deebak [email protected]
Arun G. Ramaswamy [email protected]
1
Shyam Sundar [email protected]
Department of Orthopaedics, Bangalore Medical College and Research Institute, Bangalore, India
2
David V. Rajan [email protected]
Department of Orthopaedics, Mysore Medical College, Mysore, India
3
Karthik Selvaraj [email protected]
Ortho One, Orthopaedic Specialty Hospital, 657, Trichy Road, Singanallur, Coimbatore, Tamil Nadu 641005, India
4
OrthoDent, Shenoy Nagar, Chennai, India
Santosh Sahanand [email protected]
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