Is Magnetic Resonance Imaging Assessment of the Size of Articular Cartilage Defects Accurate?

The purpose of this study was to systematically review the literature relative to the following question: Is preoperative magnetic resonance imaging (MRI) an accurate instrument for the assessment of the size of knee articular cartilage defects compared with arthroscopy? A systematic search was performed in September 2011 using PubMed MEDLINE (from 1966), CINAHL (from 1982), SPORTDiscus (from 1985), SCOPUS (from 1996), and EMBASE (from 1974) databases. Four studies (one study of Level II and three studies of Level III) were identified that met the predetermined inclusion and exclusion criteria. The ability of MRI to preoperatively assess the size of cartilage lesions was highly variable. As a result of inconsistencies between imaging techniques, the methodological variability and shortcomings of the studies, and the limited amount of data available, a meta-analysis was not performed. There is some evidence that MRI is an accurate tool for preoperatively assessing the dimensions of articular cartilage defects. However, because of the heterogeneity of MRI sequences and the paucity of literature related to preoperative sizing, it is not possible to make definitive conclusions regarding the global clinical utility of MRI for guiding the selection of therapeutic strategies.