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Relevancy and reproducibility of magnetic resonance imaging (MRI) interpretation in multiple-ligament injuries and dislocations of the knee - 19/04/13

Doi : 10.1016/j.otsr.2012.11.016 
O. Barbier a, , B. Galaud b, S. Descamps c, P. Boisrenoult d, E. Leray e, S. Lustig f, P. Bonnevialle g, P. Laffargue h, J.-L. Paillot i, P. Rosset j, P. Neyret f, D. Saragaglia k, C. Lapra l

the French Society of Orthopaedic Surgery and Traumatology (SoFCOT)m

a Bégin Military Teaching Hospital, Department of Orthopaedic and Trauma Surgery, 69, avenue de Paris, 94160 Saint-Mandé, France 
b Department of Orthopaedic and Trauma Surgery, Caen Côte-de-Nacre Teaching Hospital Center, 14033 Caen cedex, France 
c Clermont-Ferrand Teaching Hospital Center, Department of Orthopaedic and Trauma Surgery Gabriel-Montpied Hospital, 63003 Clermond-Ferrand, France 
d Department of Orthopaedic and Trauma Surgery, André-Mignot Hospital Center, 177, rue Versailles, 78150 Le Chesnay, France 
e Public Health Department, faculty of Medicine, 2, avenue du Pr-Léon-Bernard, 35043 Rennes cedex, France 
f Croix-Rousse Hospital, 8, rue de Margnolles, Albert-Trillat center for sports medicine, Livet Center, 69300 Lyon-Caluire, France 
g Department of Orthopaedic and Trauma Surgery, Toulouse Teaching Hospital Center, 1, place Docteur-Baylac, 31059 Toulouse cedex, France 
h Croise Laroche Private Hospital, 199, rue de la Rianderie, 59700 Marcq-en-Baroeul, France 
i Herbert Private Hospital, 19, chemin de Saint-Pol, 73100 Aix-Les-Bains, France 
j Department of Orthopaedic and Trauma Surgery, Trousseau Hospital, CHRU Tours, 37000 Tours, France 
k Department of Orthopaedic and Trauma Surgery, Grenoble Teaching Hospital Center, 38000 Grenoble, France 
l 25, rue Flesselles, 69001 Lyon, France 
m 52, rue Boissonnade, 75014 Paris, France 

Corresponding author.

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Summary

Introduction

After multiple-ligament injuries and dislocations of the knee, clinical assessment of the soft tissues is difficult and MRI is generally performed.

Hypothesis

MRI is a reliable examination, providing a precise and reproducible assessment of soft-tissue lesions after multiple-ligament injuries or dislocations of the knee.

Materials and methods

Forty patients presenting multiple-ligament lesions of the knee were included in this multicenter prospective study. All had an MRI of the knee in the 48h following their accident. Thirty-four patients were treated surgically. A 17-item standardized interpretation guide was created. Intraobserver reproducibility was assessed by comparing the interpretations of five surgeons at two different times 3 weeks apart. Interobserver reproducibility was evaluated by comparing the results of the interpretations of 40 MRIs performed by three pairs of surgeons. The relevance of the MRI interpretations was determined by comparing the results of the surgeons to those of a radiologist and with the data from the surgical reports.

Results

The overall intraobserver and interobserver agreement was low. Comparing the surgeon’s results with the radiologist’s results and the surgical data, the agreement was low.

Discussion

After multiple-ligament injuries and dislocations of the knee, a precise diagnosis is necessary. This study provides an isolated demonstration of the lack of precision and reproducibility of MRI interpretations for the diagnosis of the lesion’s topography. MRI should be integrated into a complete assessment with a precise clinical exam and stress X-rays.

Level of evidence

Level IV, prospective case–control study.

El texto completo de este artículo está disponible en PDF.

Keywords : Knee, Dislocation, Multiple-ligament injuries, MRI, Reproducibility


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© 2013  Publicado por Elsevier Masson SAS.
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Vol 99 - N° 3

P. 305-311 - mai 2013 Regresar al número
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