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

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

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.

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Abbreviations

OA:

Osteoarthritis

CMI:

Collagen meniscal implant

VAS:

Visual analogue satisfaction scale

PD:

Proton density-weighted

FS:

Fat saturated

BMEP:

Bone marrow edema pattern

ICC:

Intraclass correlation coefficient

SI:

Signal intensity

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Funding

This study was not funded.

Author information

Author notes

  1. Balazs K. Kovacs and Rolf Huegli contributed equally.

Authors and Affiliations

  1. Clinic of Radiology and Nuclear Medicine, University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland

    Balazs K. Kovacs, Dorothee Harder, Luca Cedro & Anna Hirschmann

  2. SportClinic Zurich Hirslanden, Witellikerstrasse 40, 8032, Zurich, Switzerland

    Roger Berbig

  3. Department of Orthopedic Surgery and Traumatology, Kantonsspital Baselland (Bruderholz, Liestal, Laufen), 4101, Bruderholz, Switzerland

    Michael T. Hirschmann

  4. Amsler Consulting, Gundeldingerrain 111, 4059, Basel, Switzerland

    Felix Amsler

  5. Department of Radiology, Kantonsspital Baselland Bruderholz, 4104, Bruderholz, Switzerland

    Rolf Huegli

  6. Department of Radiology, Kantonsspital Baden AG, Im Ergel 1, 5404, Baden, Switzerland

    Susanne Bensler

Authors
  1. Balazs K. Kovacs
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  2. Rolf Huegli
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  3. Dorothee Harder
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  4. Luca Cedro
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  5. Roger Berbig
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  6. Felix Amsler
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  7. Susanne Bensler
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  8. Michael T. Hirschmann
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  9. Anna Hirschmann
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Corresponding author

Correspondence to Anna Hirschmann.

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Conflict of interest

No conflict of interest for any of the authors.

Ethical approval

This study was approved by the local ethical committee (Ethikkommission Nordwest- und Zentralschweiz, EKNZ Nr. 2014/146).

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Kovacs, B.K., Huegli, R., Harder, D. et al. MR variability of collagen meniscal implant remodelling in patients with good clinical outcome. Knee Surg Sports Traumatol Arthrosc 29, 90–99 (2021). https://doi.org/10.1007/s00167-019-05715-9

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  • DOI: https://doi.org/10.1007/s00167-019-05715-9

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