Do cartilage repair procedures prevent degenerative meniscus changes? Longitudinal T1p and morphological evaluation with 3.0-T MRI

Pia M. Jungmann, Xiaojuan Li, Lorenzo Nardo, Karupppasamy Subburaj, Wilson Lin, C. Benjamin Ma, Sharmila Majumdar, Thomas M. Link

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

Background: Cartilage repair (CR) procedures are widely accepted for treatment of isolated cartilage defects in the knee joint. However, it is not well known whether these procedures prevent degenerative joint disease. Hypothesis: Cartilage repair procedures prevent accelerated qualitative and quantitative progression of meniscus degeneration in individuals with focal cartilage defects. Study Design: Cohort study; Level of evidence, 2. Methods: Ninety-four subjects were studied. Cartilage repair procedures were performed on 34 patients (osteochondral transplantation, n = 16; microfracture, n = 18); 34 controls were matched. An additional 13 patients received CR and anterior cruciate ligament (ACL) reconstruction (CR and ACL), and 13 patients received only ACL reconstruction. Magnetic resonance imaging at 3.0- tesla with T1p mapping and sagittal fat-saturated intermediate-weighted fast spin echo (FSE) sequences was performed to quantitatively and qualitatively analyze menisci (Whole-Organ Magnetic Resonance Imaging Score [WORMS] assessment). Patients in the CR and CR and ACL groups were examined 4 months (n = 34; n = 13), 1 year (n = 21; n = 8), and 2 years (n = 9; n = 5) after CR. Control subjects were scanned at baseline and after 1 and 2 years, ACL patients after 1 and 2 years. Results: At baseline, global meniscus T1p values (mean 6 SEM) were higher in individuals with CR (14.2±0.5 ms; P = .004) and in individuals with CR and ACL (17.1±0.9 ms; P<.001) when compared with controls (12.8±0.6 ms). After 2 years, there was a statistical difference between T1p at the overlying meniscus above cartilage defects (16.4±1.0 ms) and T1p of the subgroup of control knees without cartilage defects (12.1±0.8 ms; P<.001) and a statistical trend to the CR group (13.3±1.0 ms; P = .09). At baseline, 35% of subjects with CR showed morphological meniscus tears at the overlying meniscus; 10% of CR subjects showed an increase in the WORMS meniscus score within the first year, and none progressed in the second year. Control subjects with (without) cartilage defects showed meniscus tears in 30% (5%) at baseline; 38% (19%) increased within the first year, and 15% (10%) within the second year. Conclusion: This study demonstrated more severe meniscus degeneration after CR surgery compared with controls. However, progression of T1p values was not observed from 1 to 2 years after surgery. These results suggest that CR may prevent degenerative meniscus changes.

Original languageEnglish (US)
Pages (from-to)2700-2708
Number of pages9
JournalAmerican Journal of Sports Medicine
Volume40
Issue number12
DOIs
StatePublished - Dec 1 2012
Externally publishedYes

Keywords

  • 3.0-T MRI
  • cartilage repair
  • meniscus
  • T1p
  • WORMS

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation

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