Ahmed, Imran, Radhakrishnan, Anand, Khatri, Chetan, Staniszewska, Sophie, Hutchinson, Charles E., Parsons, Nicholas R., Price, Andrew R. G. and Metcalfe, Andrew J. (2021) Meniscal tears are more common than previously identified, however, less than a quarter of people with a tear undergo arthroscopy. Knee Surgery, Sports Traumatology, Arthroscopy, 29 . pp. 3892-3898. doi:10.1007/s00167-021-06458-2 ISSN 0942-2056.

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Abstract

Purpose:
The management of meniscal tears is a widely researched and evolving field. Previous studies reporting the incidence of meniscal tears are outdated and not representative of current practice. The aim of this study was to report the current incidence of MRI confirmed meniscal tears in patients with a symptomatic knee and the current intervention rate in a large NHS trust.

Methods:
Radiology reports from 13,358 consecutive magnetic resonance imaging scans between 2015 and 2017, performed at a large UK hospital serving a population of 470,000, were assessed to identify patients with meniscal tears. The hospital database was interrogated to explore the subsequent treatment undertaken by the patient. A linear regression model was used to identify if any factors predicted subsequent arthroscopy.

Results:
1737 patients with isolated meniscal tears were identified in patients undergoing an MRI for knee pain, suggesting a rate of 222 MRI confirmed tears per 100,000 of the population aged 18 to 55 years old. 47% attended outpatient appointments and 22% underwent arthroscopy. Root tears [odds ratio (95% CI) 2.24 (1.0, 4.49); p = 0.049] and bucket handle tears were significantly associated with subsequent surgery, with no difference between the other types of tears. The presence of chondral changes did not significantly affect the rate of surgery [0.81 (0.60, 1.08); n.s].

Conclusion:
Meniscal tears were found to be more common than previously described. However, less than half present to secondary care and only 22% undergo arthroscopy. These findings should inform future study design and recruitment strategies. In agreement with previous literature, bucket handle tears and root tears were significant predictors of subsequent surgery.

Item Type:	Journal Article
Subjects:	R Medicine > RC Internal medicine R Medicine > RD Surgery
Divisions:	Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Knee -- Wounds and injuries -- Treatment, Knee -- Surgery, Meniscus (Anatomy) , Meniscus (Anatomy) -- Surgery, Arthroscopy
Journal or Publication Title:	Knee Surgery, Sports Traumatology, Arthroscopy
Publisher:	Springer
ISSN:	0942-2056
Official Date:	November 2021
Dates:	Date Event November 2021 Published 1 February 2021 Available 18 January 2021 Accepted
Volume:	29
Page Range:	pp. 3892-3898
DOI:	10.1007/s00167-021-06458-2
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Open Access (Creative Commons)
Date of first compliant deposit:	22 June 2021
Date of first compliant Open Access:	22 June 2021
RIOXX Funder/Project Grant:	Project/Grant ID RIOXX Funder Name Funder ID DRF-2018–11-ST2-030 National Institute for Health Research http://dx.doi.org/10.13039/501100000272

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