![]() ![]() There is increasing evidence to suggest that patients with knee OA with degenerative meniscal tears who undergo an arthroscopic partial meniscectomy do not have significantly improved patient related outcome scores and more often than not require further invasive surgery soon after. Therefore, as would be expected, the progression of osteoarthritis is greater in those who suffer degenerative meniscal tears compared to traumatic tears. However, for traumatic tears which more commonly occur in the younger population, the knee more often than not has limited OA prior to injury and treatment. For these patients, who commonly present between 40 and 60 years of age, the arthritic process is likely to have started prior to meniscectomy. ĭegenerative meniscal tears are a common manifestation of OA occurring in the knee. A similar rate is seen in those followed up after surgical resection of meniscal tears. Ten to 20 years following an ACL rupture, 50% of patients will develop knee OA. Trauma resulting in damage to the anterior cruciate ligament (ACL) or menisci also predisposes the knee to the development of OA. The pathophysiological processes that lead to these osteoarthritic changes in the knee are influenced by hereditary factors, ageing, excess loading of the joint, and mechanical injuries. Changes inside the joint such as cartilage loss, osteophyte formation, meniscal tears and loose bodies can lead to manifestation of the common symptoms of knee pain, swelling and reduced mobility. The knee is the most common joint affected by osteoarthritis (OA). We suggest that whilst MRI is a useful tool in the investigation of knee symptoms, it is often unnecessarily used in patients with OA, when in fact, radiographs alone would be sufficient. KL grading especially best represents the disease seen in the medial compartment of the knee joint, with a moderate correlation to Outerbridge scores given on arthroscopic assessment. The ability of radiographs to represent the actual condition of knee osteoarthritis is underestimated. KL and MRI grading was moderately correlated for the medial compartment (SR 0.475, p < 0.001) and mildly correlated for the lateral compartment (SR 0.277, p < 0.001). MRI reporting of knee osteoarthritis was moderately correlated with Outerbridge grades in the medial compartment (SR 0.451, p < 0.001), mildly correlated for both the lateral (SR 0.299, p < 0.001) and patellofemoral joint compartments (SR 0.142, p = 0.054). Kellgren-Lawrence (KL) grading of radiographs was moderately correlated with Outerbridge grades from arthroscopy for the medial compartment of the knee (Spearman’s rho (SR) 0.483, p < 0.001), with a milder correlation in the lateral compartment (SR 0.218, p = 0.003). The Outerbridge grade given at arthroscopy was correlated with pre-operative radiograph and MRI scores, so as to assess the reliability of these imaging techniques at predicting the actual severity of knee osteoarthritis seen. This was a retrospective study looking at knee arthroscopies performed at a tertiary centre over a 5 year period. By comparing them against arthroscopic findings the aim of our study was to conclude how accurate these imaging techniques are at grading knee osteoarthritis. However, it currently remains uncertain how good a representation of the actual condition of the knee joint these investigations provide. Radiographs and MRI scans are commonly used imaging techniques in the assessment of knee osteoarthritis.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |