The role of magnetic resonance imaging in routine decision making for meniscal surgery

This clinical study evaluated factors affecting the decision for meniscal s urgery 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. W e investigated 149 patients clinically and by magnetic resonance imaging (M RI). Group A (n = 62) underwent arthroscopic surgery and group B (n = 87) w ere 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 foun d 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 clin ical examination (P = 0.5). Patients in group A were significantly older th an Chose in group B (P = 0.044), and, as expected, MRI signal alterations w ere significantly higher in group A than in group B (P = 0.001). Ln acutely injured patients MRI helps to establish an accurate diagnosis, and in case s of positive MRI findings in a symptomatic patient, the surgeon should not wait 4-6 weeks but should immediately recommend surgery.