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Beitragstitel Three-dimensional meniscus allograft sizing - a retrospective study of 280 helathy menisci
Beitragscode P049
Autoren
  1. Silvan Beeler Universitätsklinik Balgrist Vortragender
  2. Lazaros Vlachopoulos Universitätsklinik Balgrist
  3. Lukas Jud Balgrist Hospital, University of Zurich, Department of Orthopaedics
  4. Marco von Atzigen Universitätsklinik Balgrist
  5. Reto Sutter Universitätsklinik Balgrist
  6. Philipp Fürnstahl Universitätsklinik Balgrist, Zürich
  7. Sandro F. Fucentese Universitätsklinik Balgrist
Präsentationsform Poster
Themengebiete
  • A05 - Knie
Abstract Introduction:
Even in the 21stcentury, meniscus allograft sizing is done only by width and length of the meniscus in 2D MRI scan of the contralateral side, or even only in conventional radiographs of the ipsilateral side. Although it is recognized that length, width and height do not correlate and a similar 3D shape of the allograft is crucial for good results, 3D meniscus sizing has still not yet been tried.
The purpose of this study was to evaluate a new 3D meniscus sizing method to increase the accuracy of the 3D allograft shape and to reduce outliers, compared to the currently used radiographic and MRI sizing methods.

Methods:
280 3D meniscus surface models were generated out of 50 bilateral and 40 unilateral knee joint MRI scans. All together served as an imaginary meniscus allograft tissue bank. Meniscus sizing and allograft selection was done for all 50 bilateral knee joints by 1) the closest mean surface distance (MeSD) (3D-MRI sizing of the contralateral meniscus), 2) the smallest meniscal width/length difference measured in MRI (2D-MRI sizing of the contralateral meniscus) and 3) in x-ray as proposed by Pollard (2D-RX sizing of the ipsilateral tibia plateau). 3D shape (MeSD and maximum surface distance (MaSD)), as well as meniscal width, length and height were then compared between the selected and original meniscus. And all three sizing methods among each other.

Results:
Allograft selection by MeSD (3D-MRI) was in all measurement parameters superior. Especially the 3D shape was significantly improved (p < 0.001), while mean differences in meniscal width, length and height were only slightly, but not significant better (p = n.s.). Further, outliers over 5mm in width and length could be reduces by 2.8 times for medial and by 1.3 times for lateral meniscus.

Conclusion:
3D MRI sizing by MeSD of the contralateral meniscus can significantly improve meniscus allograft selection, compared to sizing only by width and length in radiography or MRI. Sizing by conventional radiography seems not to be very reliable with up to 48% outliers over 5mm.