Is there a good agreement between MRI readers for Thaunat’s classification in arthroscopically-proven meniscal ramp lesions?

Chagas-Neto, Francisco Abaeté das; Alencar, Lorena Saraiva de; Aquino, Hilanne Linhares Andrade de; Taneja, Atul K.; Magalhães, José Franco Gurgel de; Filho, Pedro Guilme Teixeira de Sousa; Nogueira-Barbosa, Marcello Henrique

doi:10.1016/j.knee.2020.12.029

Cited by 9 publications

(11 citation statements)

References 20 publications

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“…The results were even better, reaching an excellent degree of reproducibility, when the observers had to classify those lesions into the different seven types proposed by Greif et al This shows that this new classification is a good proposal, because it has good reproducibility. This agrees with what Chagas-Neto et al (16) concluded in a recent radiological study in which they showed that Thaunat's classification, on which the one by Greif et al is based, has good reproducibility when applied by trained musculoskeletal radiologists.…”

Section: Discussionsupporting

confidence: 90%

Reproducibility of MRI in the diagnosis of meniscal ramp lesions: an inter-observer study

Menéndez¹,

González²,

Morís

et al. 2022

Acta Radiol

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Background Meniscal ramp lesions have gained much prominence in recent years due to a significant increase in their diagnosis and their important biomechanical involvement in the knee. A new proposed classification of these lesions has recently been published. Purpose To evaluate the reproducibility of the new classification of meniscal ramp lesions recently published using magnetic resonance imaging (MRI). Material and Methods A total of 249 post-traumatic knee MRI studies were evaluated by three musculoskeletal radiologists independently. Patients with an anterior cruciate ligament (ACL) tear on MRI in addition to a recent history of trauma to the knee for <12 months were included in the study, for a total of 95. We carried out an inter-observer concordance study to analyze whether the new classification is reproducible to detect meniscal ramp lesions and to classify them into their different types. Results Among our study cohort of 95 patients, we found 47 (49.5%) ramp lesions. In the inter-observer study, we obtained a good concordance (k = 0.733) in the detection of these lesions and an excellent one (k = 0.843) when the type of lesion is described. Conclusion This study demonstrates that the new classification of meniscal ramp lesions has good reproducibility on MRI.

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Section: Discussionsupporting

confidence: 90%

Reproducibility of MRI in the diagnosis of meniscal ramp lesions: an inter-observer study

Menéndez¹,

González²,

Morís

et al. 2022

Acta Radiol

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“…Sonnery-Cottet et al [8] and Thaunat et al [13] classified the medial meniscocapsular tears into the following five in their MRI review study proposed the Thaunat classification [18]. In a recent study the arthroscopy classification for meniscal ramp lesions stability adapted for MRI has shown good reproducibility when applied by trained musculoskeletal radiologists [19]. The most relevant difference between arthroscopy and imaging is that the arthroscopy is performed with the knee flexed while MR is performed with the knee extended.…”

Section: Discussionmentioning

confidence: 99%

Meniscal ramp lesions: diagnostic performance of MRI with arthroscopy as reference standard

et al. 2021

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Background The posteromedial meniscal region is gaining interest among orthopedic surgeons, as lesions of this area has been reported to be significantly associated with anterior cruciate ligament tears. The current imaging literature is unclear. Purpose To evaluate the diagnostic performance of MR in the detection of meniscal ramp lesions having arthroscopy as reference standard. Materials and methods We retrospectively included 56 patients (mean age of 25 ± 7 years; 14 females) from January to November 2017 with a arthroscopically proved ACL tear and posterior meniscocapsular separation. On preoperative MRI, two radiologists with 13 and 2 years’ experience in musculoskeletal imaging assessed the presence/absence of ramp lesion, meniscotibial ligament lesion, peripheral meniscal lesion, or their combination, bone bruise. Having arthroscopy as reference standard, diagnostic performance of MRI in the evaluation of ramp area lesions was calculated. Cohen’s kappa (k) and Fisher's Exact Test statistics were used. Results Agreement between radiologists ranged from κ = 0.784 (meniscotibial ligament lesions) to κ = 0.918 red–red meniscal lesion. Sensitivities were 97.4% for ramp lesions, 95.8% for meniscotibial ligament lesion, 94.4% for peripheral meniscal lesions; specificities were 88.9%, 81.3%, and 97.4%, respectively; accuracies were 94.6%, 87.5%, and 96.4%, respectively. Agreement between MR and arthroscopy was almost perfect in identification of ramp lesions (κ = 0.871) and red–red zone meniscal lesions (κ = 0.908). The agreement between the two methods was substantial (κ = 0.751) for meniscotibial lesion. No significant association between tibial plateau bone bruise and the different type of lesions was found (κ ≥ 0.004 and p ≥ 0.08). Conclusion MR has high diagnostic performance in meniscal ramp area lesion assessment, with substantial to almost perfect inter-reader agreement.

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“…Regarding RL subtypes, intraobserver agreement was substantial for both skilled readers (k = 0.72), and moderate for the less experienced reader (k = 0.51), and interobserver agreement was moderate (k = 0.55) [9]. They concluded that Thaunat's classification adapted to MRI has good reproducibility when applied by trained musculoskeletal radiologists [9]. Moreover, Okazaki et al published a retrospective study evaluating MRI diagnostic performance in detecting RLs while imaging was conducted with the knee in extension and at 90°of flexion and compared the results to arthroscopic findings as the reference standard [34].…”

Section: Thaunat Classificationmentioning

confidence: 98%

“…Eleven of the studies from our review (52.4%), included the classification system proposed by Thaunat et al [44]. All of them reported applying the classification when performing the arthroscopic examination, and three of them additionally applied it to preoperative MRI [2,9,46].…”

Section: Thaunat Classificationmentioning

confidence: 99%

Meniscal ramp lesion classification systems: A systematic review

Allende,

Berreta,

Allahabadi

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeTo describe the proposed classification systems for meniscal ramp lesions (RLs) in the literature and evaluate their accuracy and reliability.MethodsA systematic search was conducted according to the Preferred Reporting Items for Systematic reviews and Meta‐analyses guidelines utilising PubMed, Embase and Cochrane Library databases. Level I–IV studies referencing RLs along with either an arthroscopic‐ or magnetic resonance imaging (MRI)‐based classification system used to describe RL subtypes were included.ResultsIn total, 21 clinical studies were included. Twenty‐seven (79%) of the included studies were published in 2020 or later. There were four main classification systems proposed within the literature (two arthroscopic‐, two MRI‐based), describing tear patterns, mediolateral extent, associated ligament disruption and stability of the lesion. The first classification was proposed in 2015 by Thaunat et al. and is referenced in 22 (64.7%) of the included studies. The application of the Thaunat et al. criteria to MRI showed variable sensitivity (31.70%–93.8%) and interobserver agreement (k = 0.55–0.80). The Greif et al. modification to the Thaunat et al. system was referenced in 32.4% of the included studies and had a substantial interobserver agreement (k = 0.8). Stability to probing and specific tear location were each used to classify RLs in 28.6% and 23.8% of the included clinical studies, respectively.ConclusionAlthough there has been a recent increase in the recognition and treatment of meniscal RLs, there is limited consistency in descriptive classifications used for this pathology. Current RL classification systems based on preoperative MRI have variable reliability, and arthroscopic examination remains the gold standard for diagnosis and classification.Level of EvidenceLevel IV.

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Is there a good agreement between MRI readers for Thaunat’s classification in arthroscopically-proven meniscal ramp lesions?

Cited by 9 publications

References 20 publications

Reproducibility of MRI in the diagnosis of meniscal ramp lesions: an inter-observer study

Reproducibility of MRI in the diagnosis of meniscal ramp lesions: an inter-observer study

Meniscal ramp lesions: diagnostic performance of MRI with arthroscopy as reference standard

Meniscal ramp lesion classification systems: A systematic review

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