MRI More Effective than Diagnostic Arthroscopy

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MRI More Effective than Diagnostic Arthroscopy

Magnetic resonance imaging (MRI) is well-established as a reliable imaging technique for noninvasive evaluation of the knee, yet surgical diagnostic arthroscopy is still commonly used. This study compared the diagnostic results of MRI vs. arthroscopic examination to determine which procedure was more effective and accurate in identifying or confirming ligament tears in the knee.

Fifty patients (aged 19-54) with suspected meniscus/cruciate ligament injuries of the knee and/or suspected intra-articular loose bodies and scheduled to undergo arthroscopy received a radiologist-conducted MRI examination prior to arthroscopy. The status of the menisci, cruciate ligaments, cartilage and subchondral bone was registered. Arthroscopy was then performed by orthopedic specialists without knowledge of the MRI results, and the results from the two procedures were compared.
Arthroscopy revealed 14 tears of the medial meniscus in 47 patients, whereas MRI examination revealed 21 tears. MRI also revealed nine complete lesions of the anterior cruciate ligament, whereas arthroscopic examination revealed seven lesions and two partial lesions.
Overall, 17 of the 47 patients could have avoided a diagnostic arthroscopy (in which no surgically treatable lesion was found) if MRI examination had been performed instead of diagnostic arthroscopy. These findings provide evidence for the accuracy and reliability of magnetic resonance imaging as a tool for assessing knee injuries, and further support the use of nonsurgical evaluation and care procedures.
Rappeport ED, Wieslander SB, et al. MRI preferable to diagnostic arthroscopy in knee joint injuries. Acta Orthopedica Scandinavica, 1997;68(3), pp277-81.