Retrospective quantitative cartilage and semi-quantitative morphological evaluation at 6 years after ACL reconstruction

Arch Orthop Trauma Surg. 2016 Jul;136(7):967-74. doi: 10.1007/s00402-016-2463-3. Epub 2016 May 2.

Abstract

Purpose We analyzed anterior cruciate ligament reconstruction (ACLR) patients in order to evaluate degenerative changes and the effect of meniscal insufficiency at mid-term follow-up.

Methods: Sixty subjects (40 patients at 5.9 years after ACLR, 20 healthy controls) underwent 3T MRI. Quantitative cartilage T2 mapping and morphological Whole Organ Magnetic Resonance Imaging Score (WORMS) evaluation were performed. Self-reported questionnaires were used for subjective clinical evaluation. Based on the meniscal status at ACLR, further subdivision within each compartment (lateral and medial) was made: menisci intact and menisci insufficient.

Results: The ACLR subjects showed significantly elevated T2 values and higher WORMS scores compared to the control group. T2 values of the anterior lateral femoral subcompartment were significantly higher in menisci insufficient group compared to the control group. In both compartments significantly higher WORMS scores were observed in the menisci insufficient group compared to the menisci intact group.

Conclusions: ACLR knees exhibit cartilage matrix and morphological degeneration at mid-term follow-up. Lateral meniscal insufficiency noted at ACLR presents a higher risk of developing degenerative changes than does the medial meniscus insufficiency; however, this difference may not be detected clinically.

Keywords: ACL reconstruction; Meniscus insufficiency; Osteoarthritis; T2 mapping.

MeSH terms

  • Adolescent
  • Adult
  • Anterior Cruciate Ligament Reconstruction / adverse effects
  • Anterior Cruciate Ligament Reconstruction / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Knee Injuries / surgery*
  • Knee Joint / diagnostic imaging
  • Knee Joint / surgery*
  • Magnetic Resonance Imaging / methods
  • Male
  • Meniscus / diagnostic imaging*
  • Meniscus / pathology
  • Meniscus / surgery
  • Middle Aged
  • Osteoarthritis, Knee / diagnostic imaging
  • Osteoarthritis, Knee / epidemiology
  • Osteoarthritis, Knee / etiology*
  • Retrospective Studies
  • Young Adult