ABSTRACT
Background: Considering various factors that influence meniscal repairability, Ortho One PROMT score (OPS) was proposed in 2019. With an increased understanding of factors influencing meniscal repair and by analysis of OPS predictions and repair results, a modified PROMT score (MPS) has been formulated. The objective of this study is to assess the superiority of MPS over OPS. Methods: Age, chronicity, and pattern of tears were found to be important contributors to false-negative results of OPS. Considering these factors, MPS was designed. A prospective, double-blinded study was conducted between November 2020 and May 2021. Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, positive predictive value, negative predictive value, and accuracy of both scores were calculated. Receiver Operating Characteristic (ROC) curve was plotted. Results: Of 133 meniscal tears, 100 met the inclusion criteria. In predicting meniscal repairability, OPS demonstrated sensitivity and specificity of 90.32% and 83.33% medially and 64.71% and 79.41% laterally. MPS had sensitivity and specificity of 96.77% and 88.89% medially and 82.35% and 88.24% laterally. Both scores showed good statistical significance (p < 0.05) in predicting meniscal reparability. For medial meniscus repairability, area under the ROC curve was 0.868 for OPS and 0.928 for MPS. For lateral repairability, the area under the curve was 0.721 for OPS and 0.853 for MPS. Conclusion: MPS will serve as a simple and more effective tool for surgeons to predict meniscal repairability, thus enhancing their pre-surgical preparedness. This tool will also help surgeons to realistically counsel their patients and to achieve optimal patient.
ABSTRACT
INTRODUCTION: Synovial chondromatosis is a rare, generally benign condition which affects the synovial membranes and commonly involves the large joints such as the knee, and hip. It is usually mono-articular and more common in males. Synovial chondromatosis is characterized by the presence of multiple cartilaginous nodules in the joint synovium. The definitive diagnosis is achieved after the pathological examination of the synovial tissue. It can be very destructive and can cause severe osteoarthritis, pain and malignant transformation. We present a rare case of primary synovial chondromatosis of the shoulder joint in a 31-year-old male patient. CASE PRESENTATION: A 31-year-old man presented with pain and restricted movements of left shoulder for past 6 months, which was insidious in onset and gradually progressive. He had no history of trauma, fever, loss of appetite or weight loss. No tenderness or warmth over shoulder joint was observed. Restriction of movements was observed in all directions. No abnormality was detected in central nervous, cardiovascular, respiratory, genitourinary, or gastrointestinal systems. Routine pre-operative investigations (including liver function and renal function tests) were within the normal limit, serological investigation for rheumatoid arthritis was negative. Excision biopsy of loose bodies was performed. Biopsy reported histological features ofsynovial chondromatosis. CONCLUSION: Synovial osteochondromatosis of shoulder joint, subscapular recess and along the long head of biceps is a rare case (less than 5% cases reported till date). Understanding the pathology, recognizing the radiographic and MRI appearance of primary synovial chondromatosis and differentiating it from secondary form, malignancy and other synovial pathologies are important in the diagnosis and clinical management of these patients.
