Radiology: MRI points to osteoarthritis 10 years after ACL repair

MR images acquired ten years after anterior cruciate ligament (ACL) and meniscal injuries showed surgical repair did not decrease risk for localized knee osteoarthritis, according to study results published June 29 in Radiology.

The study evaluated patients a decade after their initial injuries were diagnosed using MRI. Localized knee osteoarthritis was evident in patients, regardless of subsequent management of their injuries, including arthroscopic surgical repair, reported lead author Kasper Huétink, MD, and colleagues from the departments of radiology and orthopedics at Leiden University in the Netherlands.

The researchers utilized information from a previous multicenter study database of 855 patients, which evaluated the diagnostic value of knee MRI relative to arthroscopy in patients with knee pain from 1996 to 1997. Of these patients, 326 were selected for follow-up 10 years after the initial study.

The findings and treatment of the initial imaging study were compared with follow-up radiograph and 3T MRI findings, explained the authors.

At follow-up, researchers determined that patients with ACL ruptures had an increased risk of developing joint space narrowing, cartilaginous defects, osteophytes, bone marrow lesions and subchondral cysts medially or laterally.

Patients with medial meniscal tears were at an increased risk of developing joint space narrowing, cartilaginous defects, osteophytes and bone marrow lesions medially, Huétink and colleagues reported. Those with lateral meniscal tears were also at an increased risk of developing joint space narrowing, cartilaginous defects, osteophytes, bone marrow lesions and subchondral cysts laterally.

While the researchers found that osteoarthritis can develop in different patterns depending on the initial lesion, the treatment of meniscal tears, especially partial meniscectomy, does not decrease the risk of developing osteoarthritis as observed on radiographs or 3T MRI.

“There is a higher risk of developing knee osteoarthritis at specific sites after tearing a meniscus or cruciate ligament,” said Huétink, who noted a direct relationship between injury and long-term consequences, and said that surgery has no impact on long-term outcomes. “Irrespective of treatment, the risk factors seen on knee MR images resulted in localized development of osteoarthritis 10 years later,” they wrote.

Noting the small patient pool utilized for the study, the authors said that the long-term and short-term clinical benefits of partial meniscectomy compared to meniscal repair procedures merits further investigation.

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