ObjectivesTo develop an MR-based semi-quantitative meniscus scoring technique for postoperative assessment of the degree of meniscal resection, to test its reproducibility, and to study the relationship between the amount of resection and degenerative disease burden.MethodsWe studied the right knee of 135 participants from the Osteoarthritis Initiative that underwent meniscal surgery an average of 14years previously. The amount of meniscal resection was assessed on baseline 3.0-T MRIs and calculated as meniscus resection score (MenRS) with a range of 0 to 18. Knee abnormalities at baseline and 48months were graded using a modified Whole-Organ Magnetic Resonance Imaging Score (WORMS). Subjects were also stratified according to meniscal resection performed after injury versus without preceding injury. Statistical analysis included intra-class correlation coefficient (ICC) to determine reproducibility as well as regression models and partial correlations to correlate MenRS with WORMS outcomes.ResultsICC values for intra- and inter-observer reproducibility of MenRS were 0.980 and 0.977, respectively. Overall, the amount of meniscal resection showed a significant correlation with baseline WORMS grades: higher MenRS was associated with higher total WORMS grades (p=0.004) and cartilage (p=0.004) and ligament (p<0.001) subscores. However, no significant association between MenRS and change in WORMS grades over 48months was found. The relationship between MenRS and baseline WORMS grades did not change after adjusting for a reported history of knee injury.ConclusionsPostoperative assessment of the knee following partial meniscectomy using the newly developed MenRS showed excellent reproducibility and significant cross-sectional correlation with WORMS gradings.Key Points center dot The newly developed semi-quantitative MR-based meniscal resection score demonstrated excellent reproducibility.center dot A significant correlation between the amount of meniscal resection measured using the newly developed score and the degree of overall knee joint degenerative disease and cartilage defects was found.