Abstract
Aim
To evaluate the diagnostic value of direct magnetic resonance (MR) arthrography in detection of re-torn or unhealed menisci which were previously repaired.
Materials and methods
Twenty-six menisci of 24 symptomatic patients who had undergone a meniscus repair surgery were included in this retrospective study. These patients had been evaluated with gadolinium-enhanced direct MR arthrography. A subsequent second-look arthroscopy was performed thereafter. The findings of MR arthrography were compared with the arthroscopic findings.
Results
Sixteen recurrent meniscal lesions were detected with MR arthrography; the remaining ten repaired menisci were evaluated as healed. At second-look arthroscopy, six out of 26 repaired menisci were evaluated as completely healed. Eight of them had incomplete healing, and 12 of them were unhealed. MR arthrography had four false-negative results, but there were none false-positive results. It was arthroscopically shown that three of these four false-negative results were belonged to patients who had incomplete healing. MR arthrography had a sensitivity, specificity, and overall accuracy of 80, 100, and 84.6 %, respectively. When incomplete lesions were left out of analysis, its sensitivity and accuracy reached to 94.8 and 94.4 %.
Conclusion
The findings of this study showed that MR arthrography was a reliable diagnostic tool in evaluating previously repaired menisci. Yet diagnosis of incomplete meniscal lesions seemed to be challenging.
Similar content being viewed by others
References
DeHaven KE (1999) Meniscus repair. Am J Sports Med 27:242–250
McCauley TR (2005) MR imaging evaluation of the postoperative knee. Radiology 234:53–61
Recht MP, Kramer J (2002) MR imaging of the postoperative knee: a pictorial essay. Radiographics 22:765–774
Toms AP, White LM, Marshall TJ, Donell ST (2005) Imaging the post-operative meniscus. Eur J Radiol 54:189–198
Applegate GR, Flannigan BD, Tolin BS, Fox JM, Del Pizzo W (1993) MR diagnosis of recurrent tears in the knee: value of intraarticular contrast material. Am J Roentgenol 161:821–825
Farley TE, Howell SM, Love KF, Wolfe RD, Neumann CH (1991) Meniscal tears: MR and arthrographic findings after arthroscopic repair. Radiology 180:517–522
Lim PS, Schweitzer ME, Bhatia M, Giuliano V, Kaneriya PP, Senyk RM, Oliveri M, Johnson W, Amster B, Parker L (1999) Repeat tear of postoperative meniscus: potential MR imaging signs. Radiology 210:183–188
Ciliz D, Ciliz A, Elverici E, Sakman B, Yüksel E, Akbulut O (2008) Evaluation of postoperative menisci with MR arthrography and routine conventional MRI. Clin Imaging 32:212–219
Magee T, Shapiro M, Rodriguez J, Williams D (2003) MR arthrography of postoperative knee: for which patients is it useful? Radiology 229:159–163
Sciulli RL, Boutin RD, Brown RR, Nguyen KD, Muhle C, Lektrakul N, Pathria MN, Pedowitz R, Resnick D (1999) Evaluation of the postoperative meniscus of the knee: a study comparing conventional arthrography, conventional MR imaging, MR arthrography with iodinated contrast material, and MR arthrography with gadolinium-based contrast material. Skeletal Radiol 28:508–514
Vives MJ, Homesley D, Ciccotti MG, Schweitzer ME (2003) Evaluation of recurring meniscal tears with gadolinium-enhanced magnetic resonance imaging: a randomized, prospective study. Am J Sports Med 31:868–873
De Smet AA (2005) MR imaging and MR arthrography for diagnosis of recurrent tears in the postoperative meniscus. Semin Musculoskelet Radiol 9:116–124
Briggs KK, Kocher MS, Rodkey WG, Steadman JR (2006) Reliability, validity, and responsiveness of the Lysholm knee score and Tegner activity scale for patients with meniscal injury of the knee. J Bone Joint Surg Am 88:698–705
Scott GA, Jolly BL, Henning CE (1986) Combined posterior incision and arthroscopic intra-articular repair of the meniscus: an examination of factors affecting healing. J Bone Joint Surg Am 68:847–861
Boyd KT, Myers PT (2003) Meniscus preservation; rationale, repair techniques and results. Knee 10:1–11
Miao Y, Yu JK, Ao YF, Zheng ZZ, Gong X, Leung KK (2011) Diagnostic values of 3 methods for evaluating meniscal healing status after meniscal repair: comparison among second-look arthroscopy, clinical assessment, and magnetic resonance imaging. Am J Sports Med 39:735–742
Hantes ME, Zachos VC, Zibis AH, Papanagiotou P, Karachalios T, Malizos KN, Karantanas AH (2004) Evaluation of meniscal repair with serial magnetic resonance imaging: a comparative study between conventional MRI and indirect MR arthrography. Eur J Radiol 50:231–237
White LM, Schweitzer ME, Weishaupt D, Kramer J, Davis A, Marks PH (2002) Diagnosis of recurrent meniscal tears: prospective evaluation of conventional MR imaging, indirect MR arthrography, and direct MR arthrography. Radiology 222:421–429
Cardello P, Gigli C, Ricci A, Chiatti L, Voglino N, Pofi E (2009) Retears of postoperative knee meniscus: findings on magnetic resonance imaging (MRI) and magnetic resonance arthrography (MRA) by using low and high field magnets. Skeletal Radiol 38:149–156
Conflict of interest
The authors declare that there are no conflicts of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kececi, B., Kaya Bicer, E., Arkun, R. et al. The value of magnetic resonance arthrography in the evaluation of repaired menisci. Eur J Orthop Surg Traumatol 25, 173–179 (2015). https://doi.org/10.1007/s00590-014-1450-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00590-014-1450-z