Arthroscopic Assessment of meniscal injuries using an anatomical zone classification system: Meniscal injuries according to anatomical site

Abstract

Purpose: The present study aimed to evaluate the inter- and intra-observer reproducibility of the arthroscopic meniscus tear classification system in patients treated with meniscal suture, as well as to correlate these anatomical zones, according to the injury characteristics and the suture technique employed.

 Methods: Forty-six knee arthroscopies were analyzed for meniscal sutures. The evaluators recorded data of the zones described by Smigielski, types of injuries, meniscal vascularity, suture techniques, and types of suture knots applied to sutures. Data were analyzed with respect to inter and intra-observer agreement. All clinical and anatomical outcomes as well as the characterization of the injury and meniscal treatment were correlated.

Results: The intra- and inter-observer reproducibility (Kappa coefficient) for the arthroscopic classification system of meniscus injury proposed by Smigielski ranged from slight to moderate.

Conclusion: The zone classification defines the menisci and their relationship with the surrounding anatomic landmarks of the knee, however it has limited arthroscopic application. The practical knowledge of the classification system described in this study can help specifically guide treatment for various types of meniscal injury.