MRI Criteria for Healing at 1 Year After Repair of a Traumatic Meniscal Tear

Abstract

Background: Meniscal repair for a traumatic meniscal tear is increasingly used to preserve the meniscus. Interpreting postoperative magnetic resonance imaging (MRI) scans remains challenging, especially in symptomatic patients. There is a lack of reliable MRI criteria to affirm the healed character of a traumatic meniscal injury repair. Purpose: To identify relevant MRI criteria for meniscal healing after meniscal repair. Study Design: Case series; Level of evidence, 4. Methods: We prospectively included all patients with a traumatic meniscal injury who underwent either an isolated meniscal repair or a repair during a concomitant anterior cruciate ligament reconstruction. A standardized preoperative and postoperative clinical evaluation was performed, along with collection of functional scores—Knee injury and Osteoarthritis Outcome Score, International Knee Documentation Committee, Lysholm Score, and 36-Item Short Form Health Survey. An MRI scan was performed 1 year postoperatively and compared with the preoperative MRI scan. The following MRI aspects were analyzed: variation of morphology and fat-saturated (FS) T2 intensity signal and pre- and postoperative tear diastasis measurement. Results: Fifty patients (age, mean ± SD, 28.7 ± 8.5 years [range, 16-45 years]) who were 1 year postoperative were included. All patients were considered clinically healed had the same MRI characteristics. A signal change (FS T2) was observed from a high signal intensity fluid to a nonfluid moderate signal intensity. The morphology of the lesion was more complex: from the initial lesion, line ramifications appeared, creating the appearance of tree branches. The tear diastasis decreased (from 2.3 ± 0.5 mm [range, 1.3-3.5] to 1.1 ± 0.28 mm [range, 0.5-1.5]). Conclusion: MRI criteria confirming meniscal healing after traumatic meniscal repair at 1 year were identified: a change in the intrameniscal signal becoming nonfluid and moderate in intensity; a reduction in tear diastasis to <1.5 mm; and a change in the signal morphology of the repaired meniscus.

Do MRI Results Represent Functional Outcomes Following Arthroscopic Repair of an Isolated Meniscus Tear in Young Patients?—A Prospective Comparative Cohort Study

“…For functional knee evaluation, the Paediatric International Knee Documentation Committee (Pedi-IKDC) and Lysholm knee scores were applied, and the Tegner activity scale (TAS) was used to determine the patient's degree of sports activity. All scores were fulfilled preoperatively and at the last follow-up, with a median duration of 13 months (11)(12)(13)(14)(15) in combination with a postoperative MRI examination.…”

“…All participants of this study underwent postoperative MRI at the final follow-up, with a median of 13 months (11)(12)(13)(14)(15). The MRI was performed using 1.5-T MR equipment (SIGNA voyage system).…”

“…The assessment of the meniscus healing process continues to be a matter of concern [7][8][9][10][11][12]. Clinical and functional outcomes are typically employed to assess the state of meniscus recovery [13].…”

“…In most cases, the functional and clinical condition of young individuals improves significantly after meniscus suturing [14][15][16]. However, if the patient continues to experience persistent symptoms following this type of treatment, further tests are conducted to assess the healing condition or retear of the meniscus [12]. In such cases, the magnetic resonance imaging (MRI) test is extensively utilized and readily available [12].…”

“…However, if the patient continues to experience persistent symptoms following this type of treatment, further tests are conducted to assess the healing condition or retear of the meniscus [12]. In such cases, the magnetic resonance imaging (MRI) test is extensively utilized and readily available [12]. It has been widely accepted that clinical and imaging investigation prior to meniscus tear treatment is essential, and MRI has been the most popular and convenient diagnostic tool for detecting meniscus tears [3].…”