Skip to main content
Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 1/2015

01.01.2015 | Knee

MR-arthrography assessment after repair of chronic meniscal tears

verfasst von: Dragos Popescu, Sergi Sastre, Ana Isabel Garcia, Xavier Tomas, Diego Reategui, Miguel Caballero

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 1/2015

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The aims of this study were to assess the healing rate of repair of chronically torn meniscal tear with MR-arthrography and to evaluate the relationship between the clinical and the radiographic outcomes and the impact of the meniscal section on healing.

Methods

MR-arthrography was performed at a median of 10.5 months (range 6–55) after surgery in 28 patients and healing assessed using Henning’s criteria. All lesions were chronic (>3 months). Repairs were carried out at a median 14 months (range 6–80) from initial diagnosis. Eleven patients (39 %) had ACL ligament reconstruction as well. All lesions were located in the red or red–white zone. Patients were followed for a median of 18.5 months (range 8–68). Functional outcomes were evaluated using Barrett’s healing criteria, Lysholm and Tegner score pre- and postoperatively.

Results

Clinical healing of the lesion according to Barrett’s criteria was achieved in 24 patients (85.7 %). Both Lysholm and Tegner scores improved significantly after the surgery (p < 0.05). According to Henning’s criteria, 15 of the menisci healed completely (53.5 %), 10 partially (35.7 %) and 3 failed (10.8 %). There was no significant difference between the healing process in the posterior horn and the body of the meniscus (n.s.). No correlation was found between the healing results and the clinical scores. ACL reconstruction did not influence the healing process (n.s.). Patients waiting more than 1 year from lesion to surgery seem to have a higher rate of failure (p = 0.02).

Conclusions

The results found suggest good short-term clinical and anatomic outcomes post-repair of meniscal lesions, despite their chronic nature. Longer waiting times may have negative effects on the healing process. Partial healing occurred often, but the meniscus was painless and stable.

Level of evidence

Retrospective case series, Level IV.
Literatur
1.
Zurück zum Zitat Ahn JH, Wang JH, Yoo JC (2004) Arthroscopic all-inside suture repair of medial meniscus lesion in anterior cruciate ligament-deficient knees: results of second-look arthroscopies in 39 cases. Arthroscopy 20:936–945PubMedCrossRef Ahn JH, Wang JH, Yoo JC (2004) Arthroscopic all-inside suture repair of medial meniscus lesion in anterior cruciate ligament-deficient knees: results of second-look arthroscopies in 39 cases. Arthroscopy 20:936–945PubMedCrossRef
2.
Zurück zum Zitat Arnoczky SP, Cooper TG, Stadelmaier DM, Hannafin JA (1994) Magnetic resonance signals in healing menisci: an experimental study in dogs. Arthroscopy 10:552–557PubMedCrossRef Arnoczky SP, Cooper TG, Stadelmaier DM, Hannafin JA (1994) Magnetic resonance signals in healing menisci: an experimental study in dogs. Arthroscopy 10:552–557PubMedCrossRef
3.
Zurück zum Zitat Barrett GR, Field MH, Treacy SH, Ruff CG (1998) Clinical results of meniscus repair in patients 40 years and older. Arthroscopy 14:824–829PubMedCrossRef Barrett GR, Field MH, Treacy SH, Ruff CG (1998) Clinical results of meniscus repair in patients 40 years and older. Arthroscopy 14:824–829PubMedCrossRef
4.
Zurück zum Zitat Billante M, Diduch DR, Lunardini DJ et al (2008) Meniscal repair using an all-inside, rapidly absorbing, tensionable device. Arthroscopy 24(7):779–785PubMedCrossRef Billante M, Diduch DR, Lunardini DJ et al (2008) Meniscal repair using an all-inside, rapidly absorbing, tensionable device. Arthroscopy 24(7):779–785PubMedCrossRef
5.
Zurück zum Zitat Cannon WD Jr, Vittori JM (1992) The incidence of healing in arthroscopic meniscal repairs in anterior cruciate ligament-reconstructed knees versus stable knees. Am J Sports Med 20:176–181PubMedCrossRef Cannon WD Jr, Vittori JM (1992) The incidence of healing in arthroscopic meniscal repairs in anterior cruciate ligament-reconstructed knees versus stable knees. Am J Sports Med 20:176–181PubMedCrossRef
6.
Zurück zum Zitat Cardello P, Gigli C, Ricci A et al (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(2):149–156PubMedCrossRef Cardello P, Gigli C, Ricci A et al (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(2):149–156PubMedCrossRef
7.
Zurück zum Zitat Davis KW, Tuite MJ (2002) MR imaging of the postoperative meniscus of the knee. Semin Musculoskelet Radiol 6:35–45PubMedCrossRef Davis KW, Tuite MJ (2002) MR imaging of the postoperative meniscus of the knee. Semin Musculoskelet Radiol 6:35–45PubMedCrossRef
8.
Zurück zum Zitat DeHaven KE, Lohrer WA, Lovelock JE (1995) Long-term results of open meniscal repair. Am J Sports Med 23:524–530PubMedCrossRef DeHaven KE, Lohrer WA, Lovelock JE (1995) Long-term results of open meniscal repair. Am J Sports Med 23:524–530PubMedCrossRef
9.
Zurück zum Zitat Eggli S, Wegmuller H, Kosina J, Huckell C, Jakob RP (1995) Long-term results of arthroscopic meniscal repair: an analysis of isolated tears. Am J Sports Med 23:715–720PubMedCrossRef Eggli S, Wegmuller H, Kosina J, Huckell C, Jakob RP (1995) Long-term results of arthroscopic meniscal repair: an analysis of isolated tears. Am J Sports Med 23:715–720PubMedCrossRef
10.
Zurück zum Zitat Fairbank TJ (1948) Knee joint changes after meniscectomy. J Bone Joint Surg Br 30:664–670 Fairbank TJ (1948) Knee joint changes after meniscectomy. J Bone Joint Surg Br 30:664–670
11.
Zurück zum Zitat Farley TE, Howell SM, Love KF, Wolfe RD, Neumann CH (1991) Meniscal tears: MR and arthrographic findings after arthroscopic repair. Radiology 180:517–522PubMedCrossRef Farley TE, Howell SM, Love KF, Wolfe RD, Neumann CH (1991) Meniscal tears: MR and arthrographic findings after arthroscopic repair. Radiology 180:517–522PubMedCrossRef
12.
Zurück zum Zitat Feng H, Hong l, Geng X et al (2008) Second-look arthroscopic evaluation of bucket-handle meniscus tear repairs with ACL reconstruction: 67 consecutive cases. Arthroscopy 24(12):1358–1366PubMedCrossRef Feng H, Hong l, Geng X et al (2008) Second-look arthroscopic evaluation of bucket-handle meniscus tear repairs with ACL reconstruction: 67 consecutive cases. Arthroscopy 24(12):1358–1366PubMedCrossRef
13.
Zurück zum Zitat Gill SS, Diduch DR (2002) Outcomes after meniscal repair using the meniscus arrow in knees undergoing concurrent anterior cruciate ligament reconstruction. Arthroscopy 18(6):569–577PubMedCrossRef Gill SS, Diduch DR (2002) Outcomes after meniscal repair using the meniscus arrow in knees undergoing concurrent anterior cruciate ligament reconstruction. Arthroscopy 18(6):569–577PubMedCrossRef
14.
Zurück zum Zitat Hantes ME, Zachos VC, Zibis AH et al (2004) Evaluation of meniscal repair with serial magnetic resonance imaging: a comparative study between conventional MRI and indirect MR arthrography. Eur J Radiol 50:231–237PubMedCrossRef Hantes ME, Zachos VC, Zibis AH et al (2004) Evaluation of meniscal repair with serial magnetic resonance imaging: a comparative study between conventional MRI and indirect MR arthrography. Eur J Radiol 50:231–237PubMedCrossRef
15.
Zurück zum Zitat Henning CE, Lynch MA, Clark JR (1987) Vascularity for healing of meniscus repairs. Arthroscopy 3:13–18PubMedCrossRef Henning CE, Lynch MA, Clark JR (1987) Vascularity for healing of meniscus repairs. Arthroscopy 3:13–18PubMedCrossRef
16.
Zurück zum Zitat Horibe S, Shino K, Maeda A et al (1996) Results of isolated meniscal repair evaluated by second-look arthroscopy. Arthroscopy 12:150–155PubMedCrossRef Horibe S, Shino K, Maeda A et al (1996) Results of isolated meniscal repair evaluated by second-look arthroscopy. Arthroscopy 12:150–155PubMedCrossRef
17.
Zurück zum Zitat Horibe S, Shino K, Nakata K et al (1995) Second-look arthroscopy after meniscal repair: review of 132 menisci repaired by an arthroscopic inside-out technique. J Bone Joint Surg Br 77:245–249PubMed Horibe S, Shino K, Nakata K et al (1995) Second-look arthroscopy after meniscal repair: review of 132 menisci repaired by an arthroscopic inside-out technique. J Bone Joint Surg Br 77:245–249PubMed
18.
Zurück zum Zitat Johnson MJ, Lucas GL, Dusek JK, Henning CE (1999) Isolated arthroscopic meniscal repair: a long-term outcome study (more than 10 years). Am J Sports Med 27:44–49PubMed Johnson MJ, Lucas GL, Dusek JK, Henning CE (1999) Isolated arthroscopic meniscal repair: a long-term outcome study (more than 10 years). Am J Sports Med 27:44–49PubMed
19.
Zurück zum Zitat Kotsovolos ES, Hantes M, Mastrokalos DS et al (2006) Results of all-inside meniscal repair with the FasT-Fix meniscal repair system. Arthroscopy 22(1):3–9PubMedCrossRef Kotsovolos ES, Hantes M, Mastrokalos DS et al (2006) Results of all-inside meniscal repair with the FasT-Fix meniscal repair system. Arthroscopy 22(1):3–9PubMedCrossRef
20.
Zurück zum Zitat Kurosaka M, Yoshiya S, Kuroda R et al (2002) Repeat tears of repaired menisci after arthroscopic confirmation of healing. J Bone Joint Surg (Br) 84-B:34–37CrossRef Kurosaka M, Yoshiya S, Kuroda R et al (2002) Repeat tears of repaired menisci after arthroscopic confirmation of healing. J Bone Joint Surg (Br) 84-B:34–37CrossRef
21.
Zurück zum Zitat Lozano J, Ma CB, Cannon WD (2007) All-inside meniscus repair. Clin Orthop Relat Res 45:134–141CrossRef Lozano J, Ma CB, Cannon WD (2007) All-inside meniscus repair. Clin Orthop Relat Res 45:134–141CrossRef
22.
Zurück zum Zitat Magee T, Shapiro M, Rodriguez J, Williams D (2003) MR arthrography of postop- erative knee: for which patients is it useful? Radiology 229:159–163PubMedCrossRef Magee T, Shapiro M, Rodriguez J, Williams D (2003) MR arthrography of postop- erative knee: for which patients is it useful? Radiology 229:159–163PubMedCrossRef
23.
Zurück zum Zitat Mathieu L, Bouchard A, Marchaland JP et al (2009) Knee MR-arthrography in assessment of meniscal and chondral lesions. Orthop Traumatol Surg Res 95(1):40–47PubMedCrossRef Mathieu L, Bouchard A, Marchaland JP et al (2009) Knee MR-arthrography in assessment of meniscal and chondral lesions. Orthop Traumatol Surg Res 95(1):40–47PubMedCrossRef
24.
Zurück zum Zitat Morgan CD, Wojtys EM, Casscells CD, Casscells SW (1991) Arthroscopic meniscal repair evaluated by second-look arthroscopy. Am J Sports Med 19:632–637PubMedCrossRef Morgan CD, Wojtys EM, Casscells CD, Casscells SW (1991) Arthroscopic meniscal repair evaluated by second-look arthroscopy. Am J Sports Med 19:632–637PubMedCrossRef
25.
Zurück zum Zitat Nepple JJ, Dunn WR, Wright RW (2012) Meniscal repair outcomes at greater than five years: a systematic literature review and meta-analysis. J Bone Joint Surg Am 94(24):2222–2227PubMedCentralPubMedCrossRef Nepple JJ, Dunn WR, Wright RW (2012) Meniscal repair outcomes at greater than five years: a systematic literature review and meta-analysis. J Bone Joint Surg Am 94(24):2222–2227PubMedCentralPubMedCrossRef
26.
Zurück zum Zitat Petty CA, Lubowitz JH (2011) Does arthroscopic partial meniscectomy result in knee osteoarthritis? A systematic review with a minimum of 8 years’ follow-up. Arthroscopy 27(3):419–424PubMedCrossRef Petty CA, Lubowitz JH (2011) Does arthroscopic partial meniscectomy result in knee osteoarthritis? A systematic review with a minimum of 8 years’ follow-up. Arthroscopy 27(3):419–424PubMedCrossRef
27.
Zurück zum Zitat Ponce de Leon JC, Sierra Suarez L, Almazán Díaz A et al (2008) Meniscal repair in patients with chronic lesions. Acta Ortop Mex 22(1):12–18PubMed Ponce de Leon JC, Sierra Suarez L, Almazán Díaz A et al (2008) Meniscal repair in patients with chronic lesions. Acta Ortop Mex 22(1):12–18PubMed
28.
Zurück zum Zitat Popescu D, Sastre S, Caballero M et al (2010) Meniscal repair using the FasT-Fix device in patients with chronic meniscal lesions. Knee Surg Sports Traumatol Arthrosc 18(4):546–550PubMedCrossRef Popescu D, Sastre S, Caballero M et al (2010) Meniscal repair using the FasT-Fix device in patients with chronic meniscal lesions. Knee Surg Sports Traumatol Arthrosc 18(4):546–550PubMedCrossRef
29.
Zurück zum Zitat Pujol N, Panarella L, Si Selmi TA (2008) Meniscal healing after meniscal repair. A CT arthrography assessment. Am J Sports Med 36(8):1489–1495PubMedCrossRef Pujol N, Panarella L, Si Selmi TA (2008) Meniscal healing after meniscal repair. A CT arthrography assessment. Am J Sports Med 36(8):1489–1495PubMedCrossRef
30.
Zurück zum Zitat Rockborn P, Messner K (2000) Long-term results of meniscus repair and meniscectomy: a 13-year functional and radiographic follow-up study. Knee Surg Sports Traumatol Arthrosc 8:2–10PubMedCrossRef Rockborn P, Messner K (2000) Long-term results of meniscus repair and meniscectomy: a 13-year functional and radiographic follow-up study. Knee Surg Sports Traumatol Arthrosc 8:2–10PubMedCrossRef
31.
Zurück zum Zitat Starke C, Kopf S, Petersen W, Becker R (2009) Current concepts: meniscal repair. Arthroscopy 25(9):1033–1044PubMedCrossRef Starke C, Kopf S, Petersen W, Becker R (2009) Current concepts: meniscal repair. Arthroscopy 25(9):1033–1044PubMedCrossRef
32.
Zurück zum Zitat Tachibana Y, Sakaguchi K, Goto T et al (2010) Repair integrity evaluated by second-look arthroscopy after arthroscopic meniscal repair with the FasT-Fix during ACL reconstruction. Am J Sports Med 38(5):965–971PubMedCrossRef Tachibana Y, Sakaguchi K, Goto T et al (2010) Repair integrity evaluated by second-look arthroscopy after arthroscopic meniscal repair with the FasT-Fix during ACL reconstruction. Am J Sports Med 38(5):965–971PubMedCrossRef
33.
Zurück zum Zitat Tegner Y, Lysholm J (1985) Rating systems in the evaluation of the knee ligament injuries. Clin Orthop Relat Res 198:43–49PubMed Tegner Y, Lysholm J (1985) Rating systems in the evaluation of the knee ligament injuries. Clin Orthop Relat Res 198:43–49PubMed
34..
Zurück zum Zitat Toms AP, White LM, Marshall TJ, Donell ST (2005) Imaging the post-operative meniscus. Eur J Radiol 54(2):189–198PubMedCrossRef Toms AP, White LM, Marshall TJ, Donell ST (2005) Imaging the post-operative meniscus. Eur J Radiol 54(2):189–198PubMedCrossRef
35.
Zurück zum Zitat Totty WG, Matava MJ (2000) Imaging the postoperative meniscus. Magn Reson Imaging Clin N Am 8:271–283PubMed Totty WG, Matava MJ (2000) Imaging the postoperative meniscus. Magn Reson Imaging Clin N Am 8:271–283PubMed
36.
Zurück zum Zitat Trattnig S, Rand T, Czerny C et al (1999) Magnetic resonance imaging of the postoperative knee. Top Magn Reson Imaging 10:221–236PubMedCrossRef Trattnig S, Rand T, Czerny C et al (1999) Magnetic resonance imaging of the postoperative knee. Top Magn Reson Imaging 10:221–236PubMedCrossRef
37.
Zurück zum Zitat Van Trommel MF, Simonian PT, Potter HG, Wickiewicz TL (1998) Different regional healing rates with the outside-in technique for meniscal repair. Am J Sport Med 26(3):446–452 Van Trommel MF, Simonian PT, Potter HG, Wickiewicz TL (1998) Different regional healing rates with the outside-in technique for meniscal repair. Am J Sport Med 26(3):446–452
Metadaten
Titel
MR-arthrography assessment after repair of chronic meniscal tears
verfasst von
Dragos Popescu
Sergi Sastre
Ana Isabel Garcia
Xavier Tomas
Diego Reategui
Miguel Caballero
Publikationsdatum
01.01.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 1/2015
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-013-2552-6

Weitere Artikel der Ausgabe 1/2015

Knee Surgery, Sports Traumatology, Arthroscopy 1/2015 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Mehr Frauen im OP – weniger postoperative Komplikationen

21.05.2024 Allgemeine Chirurgie Nachrichten

Ein Frauenanteil von mindestens einem Drittel im ärztlichen Op.-Team war in einer großen retrospektiven Studie aus Kanada mit einer signifikanten Reduktion der postoperativen Morbidität assoziiert.

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

Klinikreform soll zehntausende Menschenleben retten

15.05.2024 Klinik aktuell Nachrichten

Gesundheitsminister Lauterbach hat die vom Bundeskabinett beschlossene Klinikreform verteidigt. Kritik an den Plänen kommt vom Marburger Bund. Und in den Ländern wird über den Gang zum Vermittlungsausschuss spekuliert.

TEP mit Roboterhilfe führt nicht zu größerer Zufriedenheit

15.05.2024 Knie-TEP Nachrichten

Der Einsatz von Operationsrobotern für den Einbau von Totalendoprothesen des Kniegelenks hat die Präzision der Eingriffe erhöht. Für die postoperative Zufriedenheit der Patienten scheint das aber unerheblich zu sein, wie eine Studie zeigt.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.