1
|
Arthroscopic surgery for symptomatic discoid lateral meniscus improves meniscal status assessed by magnetic resonance imaging T2 mapping. Arch Orthop Trauma Surg 2023:10.1007/s00402-023-04819-9. [PMID: 36811665 DOI: 10.1007/s00402-023-04819-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 02/13/2023] [Indexed: 02/24/2023]
Abstract
INTRODUCTION Discoid lateral meniscus (DLM) is an anatomic knee variant associated with increased tears and degeneration. This study aimed to quantify meniscal status with magnetic resonance imaging (MRI) T2 mapping before and after arthroscopic reshaping surgery for DLM. MATERIALS AND METHODS We retrospectively reviewed the records of patients undergoing arthroscopic reshaping surgery for symptomatic DLM with ≥ 2-year follow-up. MRI T2 mapping was performed preoperatively and at 12 and 24 months postoperatively. T2 relaxation times of the anterior and posterior horns of both menisci and of the adjacent cartilage were assessed. RESULTS Thirty-six knees from 32 patients were included. The mean age at surgery was 13.7 years (range 7-24), and the mean follow-up duration was 31.0 months. Saucerization alone was performed on five knees and saucerization with repair on 31 knees. Preoperatively, the T2 relaxation time of the anterior horn of the lateral meniscus was significantly longer than that of the medial meniscus (P < 0.01). T2 relaxation time significantly decreased at 12 and 24 months postoperatively (P < 0.01). Assessments of the posterior horn were comparable. The T2 relaxation time was significantly longer in the tear versus non-tear side at each time point (P < 0.01). There were significant correlations between the T2 relaxation time of the meniscus and that of the corresponding area of the lateral femoral condyle cartilage (anterior horn: r = 0.504, P = 0.002; posterior horn: r = 0.365, P = 0.029). CONCLUSIONS The T2 relaxation time of symptomatic DLM was significantly longer than that of the medial meniscus preoperatively, and it decreased 24 months after arthroscopic reshaping surgery. The meniscal T2 relaxation time of the tear side was significantly longer than that of the non-tear side. There were significant correlations between the cartilage and meniscal T2 relaxation times at 24 months after surgery.
Collapse
|
2
|
Pioger C, Saithna A, Kandhari V, Thaunat M, Vieira TD, Freychet B, Franck F, Sonnery-Cottet B. Risk Factors for Rapid Chondrolysis After Partial Lateral Meniscectomy: A Scoping Review of the Literature. Orthop J Sports Med 2021; 9:2325967120981777. [PMID: 33623798 PMCID: PMC7878953 DOI: 10.1177/2325967120981777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 08/27/2020] [Indexed: 01/15/2023] Open
Abstract
Background The occurrence of rapid chondrolysis after partial lateral meniscectomy is rare. The pathophysiology, risk factors, and outcomes of treatment have not been established. Purpose The primary aim of this study was to perform a scoping review of the literature to determine the potential risk factors and pathogenesis of rapid chondrolysis. The secondary objective was to report outcomes of treatment. Study Design Systematic (scoping) review. Methods A scoping review of the literature was conducted in accordance with the framework of Arksey and O'Malley. A search strategy based on the terms "chondrolysis" AND "knee," "chondrolysis" AND "meniscus," and "chondral damage" AND "lateral meniscus" was applied to the PubMed database on March 31, 2020. All relevant studies were included. Patient demographics and clinical data were extracted from these studies and analyzed in order to investigate the potential risk factors, pathogenesis, and outcomes of treatment for rapid chondrolysis. Results Five articles (22 cases) featuring rapid chondrolysis in the lateral compartment after partial lateral meniscectomy were identified and included. The condition occurred most frequently in patients who were young (mean age, 25.6 years), male (20/22 cases; 91%), and participating in high-intensity sports (19/22 cases; 86.4%) within 1 year of the index procedure. Half of the included study population underwent surgery for a radial tear. All professional athletes (13/13) returned to the preinjury level of sport. All authors of included studies suggested that the main causal risk factor was mechanical focal cartilage overload in the lateral compartment of the knee. Conclusion Rapid chondrolysis after partial lateral meniscectomy is a rare condition that typically occurs within 12 months of the index procedure. Younger age, male sex, high-intensity sports participation, and some meniscal tear patterns (eg, radial tear) are potentially important risk factors. Return-to-sport rates at short-term follow up are high, but no long-term studies were identified. The pathogenesis of rapid chondrolysis seems to relate to mechanical focal cartilage overload.
Collapse
Affiliation(s)
- Charles Pioger
- Centre Orthopedique Santy, FIFA Medical Centre of Excellence, Groupe Ramsay-Generale de Sante, Hôpital Privé Jean Mermoz, Lyon, France
| | - Adnan Saithna
- Kansas City University of Medicine and Biosciences, Kansas City, Kansas, USA
| | - Vikram Kandhari
- Centre Orthopedique Santy, FIFA Medical Centre of Excellence, Groupe Ramsay-Generale de Sante, Hôpital Privé Jean Mermoz, Lyon, France
| | - Mathieu Thaunat
- Centre Orthopedique Santy, FIFA Medical Centre of Excellence, Groupe Ramsay-Generale de Sante, Hôpital Privé Jean Mermoz, Lyon, France
| | - Thais D Vieira
- Centre Orthopedique Santy, FIFA Medical Centre of Excellence, Groupe Ramsay-Generale de Sante, Hôpital Privé Jean Mermoz, Lyon, France
| | - Benjamin Freychet
- Centre Orthopedique Santy, FIFA Medical Centre of Excellence, Groupe Ramsay-Generale de Sante, Hôpital Privé Jean Mermoz, Lyon, France
| | - Florent Franck
- Centre Orthopedique Santy, FIFA Medical Centre of Excellence, Groupe Ramsay-Generale de Sante, Hôpital Privé Jean Mermoz, Lyon, France
| | - Bertrand Sonnery-Cottet
- Centre Orthopedique Santy, FIFA Medical Centre of Excellence, Groupe Ramsay-Generale de Sante, Hôpital Privé Jean Mermoz, Lyon, France
| |
Collapse
|
3
|
Nishino K, Hashimoto Y, Nishida Y, Yamasaki S, Nakamura H. Magnetic Resonance Imaging T2 Relaxation Times of Articular Cartilage Before and After Arthroscopic Surgery for Discoid Lateral Meniscus. Arthroscopy 2021; 37:647-654. [PMID: 33010327 DOI: 10.1016/j.arthro.2020.09.036] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 09/18/2020] [Accepted: 09/19/2020] [Indexed: 02/02/2023]
Abstract
PURPOSE To quantitatively evaluate degeneration of articular cartilage using magnetic resonance imaging (MRI) T2 mapping before and after arthroscopic surgery for discoid lateral meniscus (DLM). METHODS We retrospectively reviewed the medical records of patients who underwent arthroscopic reshaping surgery for symptomatic DLM from September 2013 to October 2017 and who had undergone follow-up for ≥2 years. MRI T2 relaxation examinations had been performed preoperatively and at 3, 6, 12, and 24 months postoperatively. The T2 relaxation times of the whole lateral femoral condyle and the tibial plateau were assessed. In addition, the lateral femoral condyle was divided into 3 subcompartmental areas: anterior, middle, and posterior. RESULTS In total, 30 knees of 27 patients were included in this study. The patients' mean age at operation was 13.3 years (range 6-23 years), and the mean follow-up period was 31.6 months. Saucerization alone was performed in 3 knees and saucerization with repair in 27 knees. The T2 relaxation time of the whole lateral femoral condyle was significantly increased at 3 and 6 months postoperatively and significantly decreased at 12 and 24 months. The T2 relaxation time of the whole lateral tibial plateau was significantly increased at 3 months postoperatively and significantly decreased at 24 months. The T2 relaxation time of the posterior subcompartment of the lateral femoral condyle was significantly increased at 3 months and significantly decreased at 12 and 24 months. CONCLUSIONS The T2 relaxation time of the lateral femorotibial joint cartilage increased at 3 and 6 months postoperatively and then had decreased at 12 and 24 months. Quantitative MRI allowed us to monitor the substantial changes in the cartilage during the early postoperative period and the recovery at the distant time point after reshaping surgery for DLM. LEVEL OF EVIDENCE Level IV, case series.
Collapse
Affiliation(s)
- Kazuya Nishino
- Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Yusuke Hashimoto
- Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
| | - Yohei Nishida
- Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Shinya Yamasaki
- Department of Orthopaedic Surgery, Osaka City General Hospital, Osaka, Japan
| | - Hiroaki Nakamura
- Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| |
Collapse
|
4
|
Nakagawa S, Arai Y, Inoue H, Fujii Y, Kaihara K, Mikami Y. Relationship of alignment in the lower extremity with early degeneration of articular cartilage after resection of the medial meniscus: Quantitative analysis using T2 mapping. Medicine (Baltimore) 2020; 99:e22984. [PMID: 33126373 PMCID: PMC7598867 DOI: 10.1097/md.0000000000022984] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The objective of this study was to examine the relationship between cartilage degeneration early after partial medial meniscectomy and abnormal alignment in the lower extremity.The subjects were 34 patients (37 knees) with medial meniscal tear who underwent arthroscopic partial meniscectomy. MRI was performed before and 6 months after surgery. T2 mapping images in sagittal sections of medial femoral condyle were produced and 10 regions of interest were set at intervals of 10° in the articular cartilage in the femur. Subjects with an increase in T2 of ≥6% at a flexion angle of 30° were assigned to the degeneration group. Patient background, hip-knee-ankle (HKA) angle, and total resection of meniscal segments were compared between this group and the other patients to identify factors involved in degeneration of articular cartilage.T2 values 6 months after surgery in 3 ROIs at flexion angles of 30° to 50° were significantly longer than those before surgery. The preoperative HKA angle was significantly higher in the degeneration group. T2 values in articular cartilage of the femoral condyle increased earlier after meniscectomy with abnormal alignment in the lower extremity.Meniscectomy in cases with abnormal alignment may have a risk of early onset of osteoarthritis.Level of evidence: Level IV.
Collapse
Affiliation(s)
| | - Yuji Arai
- Department of Sports and Para-Sports Medicine
| | | | | | | | - Yasuo Mikami
- Department of Rehabilitation, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan,
| |
Collapse
|
5
|
Atsumi S, Hara K, Arai Y, Kamitani A, Nakagawa S, Inoue H, Kubo T. Outcomes of arthroscopic repair using the all-inside inter-leaf vertical suture technique for horizontal meniscal tears sustained in sports. Medicine (Baltimore) 2020; 99:e22609. [PMID: 33031317 PMCID: PMC7544389 DOI: 10.1097/md.0000000000022609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The aim of the study was to evaluate the outcomes of arthroscopic repair using the all-inside inter-leaf vertical suture arthroscopic technique for sports-related horizontal meniscal tears.The inter-leaf vertical suture procedure was performed to repair sports-related horizontal tears in the middle and posterior segments of the medial (11 cases) and lateral (2 cases) menisci in 13 patients (mean age: 30 ± 14 years). Pre- and post-operative Barrett criteria, Lysholm scores, and patient ability to resume sports were assessed. Magnetic resonance imaging (MRI) grades and signal intensity changes near the joint capsule were evaluated in the 9 cases among which pre- and post-operative MRI images were available.All Barrett criteria items were negative following surgery; Lysholm scores increased from 70.2 ± 13.1 before surgery to 98.9 ± 2.64 after surgery (P < .01). All patients were able to resume their sport. Preoperative MRI grade of tears was 3 for all patients; postoperative MRI grades were 1 in 3 cases, 2 in 4 cases, and 3 in 2 cases (P < .05). Importantly, MRI signal intensity at the repaired menisci near the joint capsule was reduced in 8 of these 9 cases postoperatively.The inter-leaf vertical suture procedure is associated with good outcomes for horizontal tears in the middle and posterior segments of the medial and lateral menisci. The procedure is useful and convenient.
Collapse
Affiliation(s)
- Satoru Atsumi
- Department of Orthopedics, JCHO Kyoto Kuramaguchi Medical Center
| | - Kunio Hara
- Department of Orthopedics, JCHO Kyoto Kuramaguchi Medical Center
| | - Yuji Arai
- Department of Sports and Para-Sports Medicine
| | - Aguri Kamitani
- Department of Orthopedics, JCHO Kyoto Kuramaguchi Medical Center
| | | | - Hiroaki Inoue
- Department of Orthopedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Japan
| | - Toshikazu Kubo
- Department of Orthopedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Japan
| |
Collapse
|
6
|
Qiu L, Perez J, Emerson C, Barrera CM, Zhong J, Nham F, Jose J, Lesniak BP, Kaplan LD, Baraga MG. Biochemical changes in knee articular cartilage of novice half-marathon runners. J Int Med Res 2019; 47:5671-5679. [PMID: 31566042 PMCID: PMC6862918 DOI: 10.1177/0300060519874140] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Objective To evaluate changes in knee articular cartilage of novice half-marathon runners using magnetic resonance imaging T2 relaxation time mapping. Methods Healthy subjects were recruited from local running clubs who met the following inclusion criteria: (i) age 18–45 years; (ii) body mass index less than 30 kg/m2; (iii) had participated in one half-marathon or less (none within the previous 6 months); (iv) run less than 20 km/week; (v) no previous knee injury or surgery; (vi) no knee pain. T2 signals were measured pre- and post-race to evaluate the biochemical changes in articular cartilage after the subjects run a half-marathon. Results A significant increase in the mean ± SD T2 relaxation time was seen in the outer region of the medial tibial plateau (50.1 ± 2.4 versus 54.7 ± 2.6) and there was a significant decrease in T2 relaxation time in the lateral femoral condyle central region (50.2 ± 4.5 versus 45.4 ± 2.9). There were no significant changes in the patella, medial femoral condyle and lateral tibia articular surfaces. Conclusion An increase in T2 relaxation time occurs in the medial tibial plateau of novice half-marathon runners. This limited region of increased T2 values, when compared with complete medial compartment involvement seen in studies of marathon runners, may represent an association between distance run and changes seen in articular cartilage T2 values.
Collapse
Affiliation(s)
- Leiyu Qiu
- Department of Radiology, Affiliated Hospital of Wenzhou Medical College Zhuji People's Hospital, Wenzhou, Zhejiang Province, China
| | - Jose Perez
- The University of Miami Sports Medicine Institute, University of Miami Miller School of Medicine, Coral Gables, FL, USA.,Department of Orthopedic Surgery, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL, USA
| | - Christopher Emerson
- The University of Miami Sports Medicine Institute, University of Miami Miller School of Medicine, Coral Gables, FL, USA
| | - Carlos M Barrera
- The University of Miami Sports Medicine Institute, University of Miami Miller School of Medicine, Coral Gables, FL, USA
| | - Jianping Zhong
- Department of Radiology, Affiliated Hospital of Wenzhou Medical College Zhuji People's Hospital, Wenzhou, Zhejiang Province, China
| | - Fong Nham
- Herbert Wertherim College of Medicine, Miami, FL, USA
| | - Jean Jose
- The University of Miami Sports Medicine Institute, University of Miami Miller School of Medicine, Coral Gables, FL, USA.,Department of Radiology, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL, USA
| | - Bryson P Lesniak
- The University of Miami Sports Medicine Institute, University of Miami Miller School of Medicine, Coral Gables, FL, USA.,Department of Orthopedic Surgery, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL, USA
| | - Lee D Kaplan
- The University of Miami Sports Medicine Institute, University of Miami Miller School of Medicine, Coral Gables, FL, USA.,Department of Orthopedic Surgery, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL, USA
| | - Michael G Baraga
- The University of Miami Sports Medicine Institute, University of Miami Miller School of Medicine, Coral Gables, FL, USA.,Department of Orthopedic Surgery, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL, USA
| |
Collapse
|