Diagnostic Accuracy of MRI and Arthroscopic Techniques for Meniscus and Cruciate Ligament Injuries in the Knee

Abstract

Introduction: Meniscus and cruciate ligament injuries are significant contributors to knee instability, often requiring precise diagnostic techniques to guide appropriate therapeutic interventions. Magnetic Resonance Imaging (MRI) and arthroscopy are commonly used to evaluate such injuries, but their comparative diagnostic accuracies remain under scrutiny.

Aim and Objectives: This study aims to compare the diagnostic accuracy of MRI with arthroscopic findings in assessing meniscus and cruciate ligament injuries, to identify discrepancies and assess the practical implications for surgical decision-making.

Methods: A cross-sectional study was conducted with 120 patients suspected of having meniscus or cruciate ligament injuries, who underwent both MRI and subsequent arthroscopic evaluation. The diagnostic performance of MRI was assessed by calculating its sensitivity, specificity, positive predictive value, and negative predictive value, using arthroscopy as the standard reference.

Findings: The study revealed that MRI had a high sensitivity (92%) and specificity (89%) for detecting meniscus injuries. For cruciate ligament injuries, MRI showed a sensitivity of 88% and specificity of 85%. The agreement between MRI and arthroscopic findings, assessed through Cohen's kappa, was 0.84 for meniscus injuries and 0.80 for cruciate ligament injuries, indicating a strong correlation.

Conclusion: MRI demonstrates high diagnostic accuracy and can be considered a reliable non-invasive alternative to arthroscopy in the initial evaluation of meniscus and cruciate ligament injuries. However, discrepancies primarily related to the interpretation of complex tears highlight the continued importance of arthroscopy for definitive diagnosis and therapeutic planning in ambiguous cases. The study supports the integration of MRI findings with clinical evaluation to optimize the management of knee injuries.