Meniscal tears are more common than previously identified, however, less than a quarter of people with a tear undergo arthroscopy

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 Previous studies reporting the incidence of meniscal tears are outdated and not representative of current practice.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. Level of evidence III.

The meniscal tear outcome (METRO) review: A systematic review summarising the clinical course and outcomes of patients with a meniscal tear

“…Secondly, many of the patients would not meet current national and international indications for surgery, as a result the existing evidence may be outdated [3,5]. Research on current UK clinical practice has found that only a quarter of patients with a meniscal tear on MRI actually undergo surgery [1]. Rather than including all patients with a meniscal tear in a study, we recommend further studies being performed with patients who meet the current indications for surgery and those listed for surgery.…”

“…With an incidence of 222/100,000 and accounting for 70,000 hospital admissions per year, meniscal tears are a common pathology with considerable healthcare resource utilisation [1,2]. National and international guidelines have recently been published on the management of patients with a meniscal tear [3][4][5].…”

Significant improvements in clinical outcome measures and patient satisfaction after combined all‐arthroscopic meniscal allograft transplantation and autologous chondrocyte implantation: A single‐centre longitudinal study

“…Meniscal injuries are a common diagnosis, with an estimated prevalence of 222 per 100,000 [1], often going hand-in-hand with cartilage lesions [2]. Despite advances in surgical meniscal restoration, numerous lesions remain irreparable [3], often necessitating meniscectomy [4][5][6], which can accelerate joint degeneration, leading to the development of osteoarthritis [7].…”

A Machine Learning Approach for Knee Injury Detection from Magnetic Resonance Imaging

“…One of the most frequently diagnosed knee injuries is meniscus tears, which can result from traumatic injury or degenerative changes due to age or overuse and cause ongoing knee pain, swelling, and stiffness, leading to a decline in functionality [ 3 , 4 ]. According to the literature, the incidence of meniscus tears is estimated to be 60–70 per 100,000 individuals per year, with a higher incidence among males in all age groups, ranging from 2.5:1 to 4:1 [ 5 ]. Moreover, in the United States, meniscus tears are the most frequent intra-articular knee injury [ 6 ].…”