ISAKOS: 2019 Congress in Cancun, Mexico

2019 ISAKOS Biennial Congress ePoster #1004


Arthroscopic Assessment of Meniscal Injuries Using an Anatomical Zone Classification System

Diego C. Astur, MD, PhD, São Paulo, SP BRAZIL
Bruno C. Pavei, MD, São Paulo, SP BRAZIL
Moises Cohen, MD, PhD, Prof., São Paulo, SP BRAZIL
Eduardo Vasconcelos De Freitas, MD BRAZIL
Camila Cohen Kaleka, MD, São Paulo, SP BRAZIL
Pedro Debieux, MD, PhD, São Paulo, SP BRAZIL
Daniel Esperante, MD, São Paulo, SP BRAZIL
Pedro B. Cabral, MD, Fortaleza, Ceara BRAZIL

Instituto Cohen, São Paulo, SP, BRAZIL

FDA Status Not Applicable


Arthroscopic Assessment of meniscal injuries using an anatomical zone classification system



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.


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.


34 patients with medial meniscus injury, and 12 lateral exhibited meniscus
injury. The mean age of participants was 31.9 years (SD +/-3.2 years). The intra- and
inter-observer reproducibility (Kappa coefficient) for the arthroscopic classification
system of meniscus injury proposed by Smigielski ranged from substantital to almost
perfect agreement.


The intra- and inter-observer reproducibility (kappa coefficient) of the
anatomical classification of menisci proposed by Smigielski during arthroscopic ranged
from substantial to almost perfect agreement. In addition, most of the injuries were in
the red zone (zone 4), longitudinal (zone 3 and 4). The most widely used suture
technique was the inside-out for the MM and all-inside for the LM. Cross stich and
vertical suture knots were mostly used in zones 3 and 4.