Evaluation of Meniscal Tissue after Meniscal Repair Using Ultrahigh Field MRI

The study evaluates the meniscal tissue after primary meniscal suturing using 7-Tesla (T) magnetic resonance imaging with T2* mapping at 6 and 12 months after surgery to investigate the differences between repaired meniscal tissue and healthy meniscal tissue in the medial and lateral compartment. This prospective study included 11 patients (9m/2f) with a mean age of 30.6 years (standard deviation 9.0). Patients with a meniscal tear that was treated arthroscopically with meniscus suturing, using an all-inside technique, were included. All patients and seven healthy volunteers were imaged on a 7-T whole-body system. T2* mapping of the meniscus was applied on sagittal slices. Regions-of-interest were defined manually in the red and white zone of each medial and lateral meniscus to measure T2*-values. In the medial posterior and medial anterior horn similar T2*-values were measured in the red and white zone at 6- and 12-month follow-up. Compared with the control group higher T2*-values were found in the repaired medial meniscus. After 12-months T2*-values decreased to normal values in the anterior horn and remained elevated in the posterior horn. In the red zone of the lateral posterior horn a significant decrease in the T2*-values (from 8.2 milliseconds to 5.9 milliseconds) (p = 0.04), indicates successful repair; a tendency toward a decrease in the white zone between the 6 and 12 months follow-up was observed. In the red zone of the lateral anterior horn the T2*-values decreased significantly during follow-up and in the white zone of the lateral anterior horn T2*-values were comparable. In comparison to the control group higher T2*-values were measured at 6-months; however, the T2*-values showed comparable values in the repaired lateral meniscus after 12 months. The T2* mapping results of the current study indicated a better healing response of the red zone of the lateral posterior horn compared with the medial posterior horn.

[1]  V. Mlynárik,et al.  Magnetic Resonance Imaging of the Musculoskeletal System at 7T , 2019, Topics in magnetic resonance imaging : TMRI.

[2]  Weili Lin,et al.  Investigating magnetic susceptibility of human knee joint at 7 Tesla , 2017, Magnetic resonance in medicine.

[3]  Alan L. Zhang,et al.  The cost-effectiveness of meniscal repair versus partial meniscectomy: A model-based projection for the United States. , 2016, The Knee.

[4]  F. Eckstein,et al.  Partial meniscectomy is associated with increased risk of incident radiographic osteoarthritis and worsening cartilage damage in the following year , 2016, European Radiology.

[5]  Xiaojuan Li,et al.  Improved differentiation between knees with cartilage lesions and controls using 7T relaxation time mapping , 2015, Journal of orthopaedic translation.

[6]  G. Geutjens,et al.  All-inside meniscal repair surgery: factors affecting the outcome , 2015, Journal of Orthopaedics and Traumatology.

[7]  H. Potter,et al.  Quantitative Ultrashort Echo Time Magnetic Resonance Imaging Evaluation of Postoperative Menisci: a Pilot Study , 2015, HSS Journal ®.

[8]  B. Wolf,et al.  Meniscal Repair with Concurrent Anterior Cruciate Ligament Reconstruction: Operative Success and Patient Outcomes at 6-Year Follow-up , 2014, Orthopaedic Journal of Sports Medicine.

[9]  Freddie H. Fu,et al.  Quantitative Magnetic Resonance Imaging UTE-T2* Mapping of Cartilage and Meniscus Healing After Anatomic Anterior Cruciate Ligament Reconstruction , 2014, The American journal of sports medicine.

[10]  O. Bieri,et al.  Quantitative MRI analysis of menisci using biexponential T2* fitting with a variable echo time sequence , 2014, Magnetic resonance in medicine.

[11]  S Trattnig,et al.  High‐resolution Fourier‐encoded sub‐millisecond echo time musculoskeletal imaging at 3 Tesla and 7 Tesla , 2013, Magnetic resonance in medicine.

[12]  Siegfried Trattnig,et al.  Repair tissue quality after arthroscopic autologous collagen-induced chondrogenesis (ACIC) assessed via T2* mapping , 2013, Skeletal Radiology.

[13]  H. Potter,et al.  Correlation of meniscal T2* with multiphoton microscopy, and change of articular cartilage T2 in an ovine model of meniscal repair. , 2013, Osteoarthritis and cartilage.

[14]  P. Austin,et al.  A Matched-Cohort Population Study of Reoperation After Meniscal Repair With and Without Concomitant Anterior Cruciate Ligament Reconstruction , 2013, The American journal of sports medicine.

[15]  W. Dunn,et al.  Meniscal repair outcomes at greater than five years: a systematic literature review and meta-analysis. , 2012, The Journal of bone and joint surgery. American volume.

[16]  Brian J Cole,et al.  Effects of Serial Sectioning and Repair of Radial Tears in the Lateral Meniscus , 2012, The American journal of sports medicine.

[17]  G. Gold,et al.  UTE T2∗ mapping detects sub-clinical meniscus degeneration. , 2012, Osteoarthritis and cartilage.

[18]  Y. Qian,et al.  UTE-T2∗ mapping detects sub-clinical meniscus injury after anterior cruciate ligament tear. , 2012, Osteoarthritis and cartilage.

[19]  Yan Ma,et al.  Dynamic contact mechanics of radial tears of the lateral meniscus: implications for treatment. , 2012, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[20]  C. Harner,et al.  Changes in tibiofemoral contact mechanics following radial split and vertical tears of the medial meniscus an in vitro investigation of the efficacy of arthroscopic repair. , 2011, The Journal of bone and joint surgery. American volume.

[21]  T. Hoffelner,et al.  Arthroscopic all-inside meniscal repair—Does the meniscus heal? , 2011, Skeletal Radiology.

[22]  Martin Logan,et al.  Meniscal Repair in the Elite Athlete , 2009, The American journal of sports medicine.

[23]  Sharmila Majumdar,et al.  Meniscal measurements of T1rho and T2 at MR imaging in healthy subjects and patients with osteoarthritis. , 2008, Radiology.

[24]  R. Siebold,et al.  Arthroscopic all-inside repair using the Meniscus Arrow: long-term clinical follow-up of 113 patients. , 2007, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[25]  Gregory P. Lee,et al.  Deteriorating Outcomes after Meniscal Repair Using the Meniscus Arrow in Knees Undergoing Concurrent Anterior Cruciate Ligament Reconstruction , 2005, The American journal of sports medicine.

[26]  M. Englund,et al.  Patellofemoral osteoarthritis coexistent with tibiofemoral osteoarthritis in a meniscectomy population , 2005, Annals of the rheumatic diseases.

[27]  A. L. Haas,et al.  Meniscal repair using the FasT-Fix all-inside meniscal repair device. , 2005, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[28]  G. Bydder,et al.  Contrast-enhanced MRI of the menisci of the knee using ultrashort echo time (UTE) pulse sequences: imaging of the red and white zones. , 2004, The British journal of radiology.

[29]  A. Karantanas,et al.  Evaluation of meniscal repair with serial magnetic resonance imaging: a comparative study between conventional MRI and indirect MR arthrography. , 2004, European journal of radiology.

[30]  K. Verstraete,et al.  Arthroscopic meniscus repair: inside-out technique vs. Biofix meniscus arrow , 2004, Knee Surgery, Sports Traumatology, Arthroscopy.

[31]  Freddie H. Fu,et al.  Current concepts in meniscus surgery: resection to replacement. , 2003, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[32]  Mark Bydder,et al.  Magnetic Resonance: An Introduction to Ultrashort TE (UTE) Imaging , 2003, Journal of computer assisted tomography.

[33]  S. Tennant,et al.  Meniscal movement. An in-vivo study using dynamic MRI. , 1999, The Journal of bone and joint surgery. British volume.

[34]  F. Barber,et al.  Meniscus repair rehabilitation with concurrent anterior cruciate reconstruction. , 1997, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[35]  Freddie H. Fu,et al.  Functional anatomy and biomechanics of the meniscus , 1994 .

[36]  E. Wojtys,et al.  Arthroscopic meniscal repair evaluated by second-look arthroscopy , 1991, The American journal of sports medicine.

[37]  B. Baker,et al.  Review of meniscal injury and associated sports , 1985, The American journal of sports medicine.