MR variability of collagen meniscal implant remodelling in patients with good clinical outcome.

Autor: Kovacs BK; Clinic of Radiology and Nuclear Medicine, University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland., Huegli R; Department of Radiology, Kantonsspital Baselland Bruderholz, 4104, Bruderholz, Switzerland., Harder D; Clinic of Radiology and Nuclear Medicine, University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland., Cedro L; Clinic of Radiology and Nuclear Medicine, University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland., Berbig R; SportClinic Zurich Hirslanden, Witellikerstrasse 40, 8032, Zurich, Switzerland., Amsler F; Amsler Consulting, Gundeldingerrain 111, 4059, Basel, Switzerland., Bensler S; Department of Radiology, Kantonsspital Baden AG, Im Ergel 1, 5404, Baden, Switzerland., Hirschmann MT; Department of Orthopedic Surgery and Traumatology, Kantonsspital Baselland (Bruderholz, Liestal, Laufen), 4101, Bruderholz, Switzerland., Hirschmann A; Clinic of Radiology and Nuclear Medicine, University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland. anna.hirschmann@usb.ch.
Jazyk: angličtina
Zdroj: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA [Knee Surg Sports Traumatol Arthrosc] 2021 Jan; Vol. 29 (1), pp. 90-99. Date of Electronic Publication: 2019 Sep 28.
DOI: 10.1007/s00167-019-05715-9
Abstrakt: Purpose: Collagen meniscal implants (CMI) have variable imaging findings on MRI and it remains ambiguous, if alterations may be present in asymptomatic patients. The aim was, to evaluate MR morphological characteristics and volume of CMI in the early, mid- and long-term follow-up.
Methods: Fifty-seven patients (mean age, 43.6±11 years; 41 male/16 female) with good clinical outcome (subjective visual analogue scale for satisfaction < 2 and a Lysholm-score ≥ 84) after CMI were assessed retrospectively using MRI 1, 2 and 3-8 years postoperatively. CMI morphology, signal intensity (SI), homogeneity and size were assessed and a meniscal score was calculated. Chondral defects and bone marrow edema pattern were reported and summarized in a chondral score. Meniscal extrusion and volume were evaluated. Intra- and inter-reader reliabilities were calculated. Spearman and partial correlations were used (p < 0.05).
Results: One year postoperatively, the CMI varied in size [10% (4/40) normal, 30% (12/40) small, 60% (24/40) hypertrophic] and was hyperintense and inhomogeneous in all patients. At long-term follow-up, the size of CMI decreased [6% (1/17) resorbed, 18% (3/17) normal, 41% (7/17) small, 35% (6/17) hypertrophic]. The SI of the CMI changed to normal in only 13% (2/16). The majority was still hyperintense [87% (14/16)]. Less meniscal extrusion was present in the follow-up [71% (11/16) versus initially 93% (37/40)]. The meniscal score improved significantly (ρ = 0.28). Over time, full-thickness femoral chondral defects were increasingly present [65% (10/17) versus initially 33% (13/40)] and the chondral score worsened significantly (p = 0.017).
Conclusion: Abnormal and inhomogeneous SI and irregular margins of the early postoperative CMI on MRI are findings seen in patients with good clinical results and should not necessarily be overcalled when reporting MRI. These features tend to decrease over time.
Level of Evidence: IV.
Databáze: MEDLINE
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