Meniscal sizing before allograft: Comparison of three imaging techniques

• Published in: The knee Vol. 25; no. 5; pp. 841 - 848
• Main Authors: Haen, T.X., Boisrenoult, P., Steltzlen, C., Pujol, N.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.10.2018; Elsevier Limited
• Subjects: Accuracy; Adult; Allograft; Allografts; Arthritis; Arthrography; Computed tomography; Correlation analysis; CT arthrography; Data imaging; Female; Humans; Knee; Knee Joint - diagnostic imaging; Knee Joint - surgery; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; Medical imaging; Menisci, Tibial - diagnostic imaging; Menisci, Tibial - transplantation; Meniscus; Metaphysis; Methods; Middle Aged; MRI; NMR; Nuclear magnetic resonance; Organ Size; Orthopedic Procedures - methods; Preoperative Period; Radiographs; Radiography; Sizing; Studies; Surgery; Tomography, X-Ray Computed; Transplantation; Meniscus; Allograft; Sizing; CT arthrography; MRI; Radiographs
• ISSN: 0968-0160; 1873-5800
• DOI: 10.1016/j.knee.2018.06.009

Accuracy of meniscal sizing is an important issue before allograft transplantation. To date, there is no consensus on the best imaging method. The purpose of this study was to compare plain radiographs, magnetic resonance imaging (MRI) and computed tomography (CT) arthrography in the assessment of meniscal size. We hypothesized that MRI and CT arthrography had better correlations than plain radiographs. All patients operated on by meniscal allograft between January 2005 and May 2015 were screened. Among them, 32 patients had both preoperative radiographs, MRI and CT arthrography of the affected knee. The meniscal dimensions were evaluated, blindly and randomly, using three imaging methods. A correlation analysis between each technique was made. For radiographic methods, an additional comparison was made between original Pollard's method and the modified method (Yoon). Bone dimensions (tibial metaphysis) were also collected, using radiographs and MRI, in order to build new equations allowing determination of meniscal dimensions from those bone measurements. The radiographic methods offered satisfying evaluations of the meniscal dimensions in the sagittal plane, without significant difference when compared with CT arthrography or MRI. In the frontal plane, the radiograph methods were less effective. With new equations, allowing determination of meniscal dimensions from tibial plateau dimensions, the mean correlation coefficient was 0.39 (0.14–0.71). The correlation between radiographic methods and MRI depended on which parameter (frontal or sagittal) was measured. Thus, we proposed a new method for sizing of meniscus, easily measurable from bony landmarks, aiming to improve the accuracy of graft selection.