Meta-analysis of preoperative MRI findings influence clinical outcomes in patients receiving knee joint replacement surgery

This meta-analysis aimed to undertake a systematic and detailed appraisal of how preoperative magnetic resonance imaging (MRI) observations correlate with functional recovery endpoints in patients treated with unicompartmental knee arthroplasty. Observational studies on preoperative MRI examinations and postoperative outcomes in patients undergoing unicompartmental knee arthroplasty (UKA) were systematically retrieved from PubMed, Embase, the Cochrane Library, Web of Science, CNKI, Wanfang Data, and VIP Chinese Science and Technology Journals Database, with the search cutoff date set at the end of October 2025. The methodological rigor of the included research was appraised utilizing the Newcastle-Ottawa Scale (NOS). All meta-analytic computations were performed using Review Manager (RevMan). For continuous data outcomes, the analytic approach employed the mean difference (MD) supplemented by its associated 95% confidence interval (CI). The final analysis comprised seventeen observational studies, covering an aggregate of 2782 knee procedures. Pooled results from the meta-analysis indicated that patients assigned to the preoperative MRI abnormal cohort demonstrated notably inferior functional performance on the Knee Society Score - Functional (KSS-F) scale (MD = 1.87, 95% CI: 1.53–2.21, P < 0.00001). Furthermore, a statistically significant decrease was observed in their Knee Injury and Osteoarthritis Outcome Score (KOOS) values relative to the normal group (MD = 4.20, 95% CI: 0.95–7.45, P = 0.01). However, comparative assessment of several other postoperative clinical parameters-including Range of Motion (ROM), the Knee Society Score - Objective (KSS-O), the Oxford Knee Score (OKS), the overall Knee Society Score (KS), Knee Society Pain Scores, and the Hospital for Special Surgery (HSS) score—failed to reveal any statistically significant intergroup disparities ( P > 0.05). Preoperative MRI-detected abnormalities were associated with a slight decrease in some functional indices (KSS-F and KOOS) after UKA. However, these abnormalities did not significantly affect most core joint function and pain scores.