Preoperative Mri Abnormalities Are Not Associated With Poor Outcomes or Altered Surgical Planning in Unicompartmental Knee Arthroplasty: A Systematic Review and Meta-Analysis Publisher



Aa Salmani Ali AKBAR ; Y Khani YASHAR ; M Shojaei MOHAMMADKAZEM ; F Rashidid FARID ; R Abedi Azar RAMILA ; A Darzi Dehkalani ALI ; M Ghazanfari Hashemi MOHAMAD ; K Adibmoradi Langroudi KHAZAR ; A Mehrvar AMIR
Source: European Journal of Orthopaedic Surgery and Traumatology Published:2025

Abstract

Purpose: To evaluate the association between preoperative MRI imaging and clinical outcomes following Unicompartmental knee arthroplasty (UKA). Methods: We searched PubMed, Scopus, Web of Science, and Embase for studies related to preoperative MRI abnormalities and clinical outcomes in patients undergoing UKA. The quality assessment was done by the National Institutes of Health’s (NIH) Study Quality Assessment Tools. A random-effects model with Hedges’g (standardized mean difference, SMD) and 95% confidence intervals (CIs) was used to assess the impact of meniscal injury and bone marrow lesions (BMLs) on clinical outcomes. Results: 18 studies (2751 patients) were included. The meta-analysis found that preoperative meniscal injury (Hedges’ g = − 0.060, p = 0.544) and bone marrow lesions (Hedges’ g = − 0.197, p = 0.386) did not significantly impact clinical outcomes following UKA. Other MRI abnormalities, such as those affecting the anterior cruciate ligament (ACL) integrity, did not impact the functional outcomes. However, findings regarding cartilage defects were inconsistent. Conclusion: Preoperative MRI features such as meniscus injury, BML, and ACL integrity did not result in equivalent clinical outcomes following UKA and may not necessitate altering the surgical plan. Surgeons should integrate MRI findings with clinical assessment and patient-specific factors rather than relying solely on these imaging abnormalities to guide decision-making. © 2025 Elsevier B.V., All rights reserved.