In a prospective study of 50 patients with suspected tear of the meniscus of the knee, the clinical diagnosis, arthrographic and arthroscopic findings were compared at arthro-tomy. The clinical diagnosis was correct in 85%, arthrographic in 54%, and arthroscopy in 91%of the patients.
We attempted to compare the accuracy of our clinical examination and the usage of magnetic resonance imaging (MRI) in evaluating patients suspected of having internal derangement of the knee who were seen in our Orthopaedic clinic. This was done using the findings of arthroscopy as the 'gold standard'. The accuracy of MRI in detecting cruciate ligament tears was between 80-96% against 82-93% for clinical examination. MRI accuracy for meniscus injuries was 80-84% compared to 48-65% for clinical examination. We thus propose that MRI examination is an effective first-line investigation for patients with suspected internal knee derangement, especially menisci injuries; allowing arthroscopy to be reserved for patients in whom surgery is truly indicated.
Study site: Orthopedic clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
Between January 1994 to December 1998, 133 patients had a meniscal surgery at University Malaya Medical Centre. Fifty-four patients were assessed and scored with the Lysholm and Tegner scoring system. Twenty-nine patients had partial meniscectomies and 25 had meniscus repair. The outcome was successful in 80% with meniscal repair and 51.7% with partial meniscectomy. The outcome of meniscal repair in this study is comparable to other reported series. However, the failure rate for partial meniscectomy was high.