Special Considerations and Pitfalls

Ali Naraghi, FRCR, Lawrence White, MD*

Mount Sinai Hospital and University Health Network, Department of Diagnostic Imaging, 600 University Avenue, Toronto, Ontario, Canada, M5G 1X5

dvances in orthopedic and arthroscopic surgical techniques have re sulted in an increase in the number of patients undergoing reconstruc tive knee arthroscopy with approximately 632,000 procedures being performed annually in the United States [1]. As a consequence of these developments, there has been an increasing demand for MRI evaluation of postoperative patients with residual or recurrent symptoms. Such symptoms may be related to surgical failure, complications of the surgical technique, or may arise as a result of reinjury. MRI has the advantage of providing a noninvasive assessment of the postoperative knee, thus avoiding the potential morbidity of further surgical exploration. However, this necessitates an understanding of the normal postoperative appearances and the MRI manifestations of failure and potential complications.

Meniscal surgery, ligamentous reconstruction, in particular anterior cruciate ligament (ACL) reconstruction, and cartilage repair procedures are the most commonplace repair procedures currently undertaken. The variability of the normal postoperative MRI appearances and changes associated with failure and common complications will be discussed. In addition the need for modification of MRI techniques for optimal evaluation of the postoperative knee will be reviewed.

As with preoperative knees, meniscal pathology remains the most frequent reason for imaging of postoperative patients. Improved understanding of the role of the menisci in force transmission, shock absorption, joint lubrication, and maintenance of joint stability as well as demonstration of the deleterious effects of total meniscectomy on articular cartilage [2-4] have led to evolution of surgical techniques such as partial meniscectomy and meniscal repair with the goal

*Corresponding author. E-mail address: [email protected] (L. White).

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