McMurray Test:A Prediction Of Arthroscopic Meniscectomy Outcomes In Patients With Knee Osteoarthritis

Background and PurposesArthroscopic surgery plays a controversial role in the management of meniscal tear associated with osteoarthritis because of its unpredictable clinical outcomes. Nowadays controversy about arthroscopic meniscectomy toward patients with osteoarthritis focus on the patients’ selection criteria. Supporters of arthroscopy argue that patients with "symptomatic meniscal tear" need surgical interference, and removal of unstable meniscal fragments for patients with osteoarthritis has been shown to be beneficia. However, symptomatic meniscal tear is not a precise definition and it is hard to diagnose symptomatic meniscal tear correctly.As McMurray sign is a significant physical indication for meniscal tear, especially for unstable meniscal tear, we hypothesized that, maybe, McMurray sign is not only an indication of "symptomatic meniscal tear", but also a presage of better postoperative outcomes. This study compares McMurray test with arthroscopic examination in patients wtih knee osteoarthritis. The analysis of the sensitivity and specificity of McMurray test and the relativity between McMurray sign and postoperative outcomes helps us to determine the candidates for arthroscopic meniscectomy. MethodsFrom March2008to August2011,149patients (mean age:58.8years), who were diagnosed as "meniscal lesion with osteoarthritis" by radiological imaging, underwent the arthroscopic surgery at our hospital. According to whether he or she had a clear McMurray sign preoperatively, all these patients were divided into several groups for compare. The sensitivity and specificity of preoperative McMurray test were confirmed by arthroscopic examination. Major clinical assessments were Lysholm scores and visual analog scale (VAS) scores. The mean follow-up period was12months.ResultsThe sensitivity and specificity of preoperative McMurray test were79.27%and67.16%respectively. The mean Lyshohn scores of the group comprised of the patients with positive McMurray sign increased from43.25preoperative to75.82postoperative (P<0.5) while their VAS scores decreased from7.91preoperative to3.07postoperative (P<0.5).ConclusionsIn patients with mensical tear associated with osteoarthritis, positive McMurray sign implies better postoperative outcomes. In the management of patients with osteoarthritis, those whose positive McMurray sign is in line with his radiological findings, can be eligible candidates for arthroscopic meniscectomy.