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Arthroscopic all-inside meniscal repair—Does the meniscus heal?

A clinical and radiological follow-up examination to verify meniscal healing using a 3-T MRI

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Abstract

Objective

The purpose of this study was to correlate clinical and radiological results using a 3-T MRI to verify meniscal healing after arthroscopic all-inside meniscus repair.

Materials and methods

We selected 27 patients (14 men and 13 women) with an average age of 31 ± 9 years and retrospective clinical examinations and radiological assessments using a 3-T MRI after all-inside arthroscopic meniscal repair were conducted. Repair of the medial meniscus was performed in 19 patients and of the lateral meniscus in eight. In 17 patients (63%), we performed concomitant anterior cruciate ligament reconstruction. The mean follow-up period was 4.5 ± 1.7 years. The Lysholm score and Tegner activity index were used for clinical evaluation. Four grades were used to classify the radiological signal alterations within the meniscus: central globular (grade 1); linear horizontal or band-like (grade 2); intrameniscal alterations and linear signal alterations communicating with the articular surface (grade 3); and complex tears (grade 4).

Results

At follow-up, the average Lysholm score was 76 ± 15 points, with ten of the patients placed in group 6 based on the Tegner activity index. MRI examinations revealed no signal alteration in three patients, grade 1 in 0, grade 2 in five, grade 3 in 13, and grade 4 in six. The MRI findings correlated positively with the clinical scores in 21 patients (78%).

Conclusions

Correlation of clinical and radiological examination was performed using 3-T MRI. In spite of satisfactory clinical outcomes at follow-up, a radiological signal alteration may still be visible on MRI, which was believed to be scar tissue, but could not be proven definitively. Imaging with a 3-Tesla MRI after meniscal suture surgery provides good but no definitive reliability on meniscus healing and therefore gives no advantage compared to 1.5-T MRI, with good clinical outcome using an all-inside arthroscopic meniscal repair.

Clinical relevance

3T-MRI can not substitute diagnostic arthroscopy in patients with persistent complaints after arthroscopic all-inside meniscal repair.

Level of evidence

Retrospective case series (EBM Level IV)

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Authors and Affiliations

  1. Department of Traumatology and Sports Injuries, 5020, Muellner Hauptstrasse 48, Salzburg, Austria

    Thomas Hoffelner, Herbert Resch, Mayer Michael & Mark Tauber

  2. Department of Radiology, University Hospital of Salzburg, Salzburg, Austria

    Rosemarie Forstner

  3. Department of Organismic Biology, University of Salzburg, Salzburg, Austria

    Bernd Minnich

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  1. Thomas Hoffelner
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  2. Herbert Resch
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  3. Rosemarie Forstner
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  4. Mayer Michael
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Correspondence to Thomas Hoffelner.

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Hoffelner, T., Resch, H., Forstner, R. et al. Arthroscopic all-inside meniscal repair—Does the meniscus heal?. Skeletal Radiol 40, 181–187 (2011). https://doi.org/10.1007/s00256-010-0965-6

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  • DOI: https://doi.org/10.1007/s00256-010-0965-6

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