Postoperative MRI plays a vital role in the assessment of patients who have undergone reconstructive knee surgery. Knowledge of the spectrum of normal, acceptable postsurgical appearances is crucial to interpretation of MRIs in patients with previous surgery, as signal and morphological changes considered pathological in the preoperative knee may routinely be visualized following repair without indicating operative failure or complications. As a result, refined diagnostic criteria are relied on in conjunction with other findings in the MR diagnosis of complications or reinjury of the knee following biologic surgical reconstruction and repair. An accurate history of prior surgical intervention, access to preoperative imaging, and a background knowledge of anticipated surgical goals may be of paramount importance in aiding ultimate image evaluation.


[1] Rutkow IM. Surgical operations in the United States. Then (1983) and now (1994). Arch Surg 1997;132(9):983-90.

[2] Krause WR, Pope MH, Johnson RJ, et al. Mechanical changes in the knee after meniscectomy. J Bone Joint Surg Am 1976;58(5):599-604.

[3] Sommerlath K. The importance of the meniscus in unstable knees. A comparative study. Am J Sports Med 1989;17(6):773-7.

[4] Shoemaker SC, Markolf KL. The role of the meniscus in the anterior-posterior stability of the loaded anterior cruciate-deficient knee. Effects of partial versus total excision. J Bone Joint Surg Am 1986;68(1):71-9.

[5] Reicher MA, Hartzman S, Duckwiler GR, et al. Meniscal injuries: detection using MR imaging. Radiology 1986;159(3):753-7.

[6] CruesJV3rd, MinkJ, LevyTL, etal. Meniscal tears of the knee: accuracy of MR imaging. Radiology 1987;164(2):445-8.

[7] Mink JH, Levy T, Crues JV 3rd. Tears of the anterior cruciate ligament and menisci of the knee: MR imaging evaluation. Radiology 1988;167(3):769-74.

[8] Deutsch AL, MinkJH, FoxJM, etal. Peripheral meniscal tears: MR findings after conservative treatment or arthroscopic repair. Radiology 1990;176(2):485-8.

[9] Farley TE, Howell SM, Love KF, et al. Meniscal tears: MR and arthrographic findings after arthroscopic repair. Radiology 1991;180(2):517-22.

[10] Smith DK, Totty WG. The knee after partial meniscectomy: MR imaging features. Radiology 1990;176(1):141-4.

[11] Kent RH, Pope CF, Lynch JK, et al. Magnetic resonance imaging of the surgically repaired meniscus: six-month follow-up. Magn Reson Imaging 1991;9(3):335-41.

[12] De Smet AA. MR imaging and MR arthrography for diagnosis of recurrent tears in the postoperative meniscus. Semin Musculoskelet Radiol 2005;9(2):116-24.

[13] Bronstein R, Kirk P, Hurley J. The usefulness of MRI in evaluating menisci after meniscus repair. Orthopedics 1992;15(2):149-52.

[14] Eggli S, Wegmuller H, KosinaJ, etal. Long-term results of arthroscopic meniscal repair. An analysis of isolated tears. Am J Sports Med 1995;23(6):715-20.

[15] Lim PS, Schweitzer ME, Bhatia M, etal. Repeat tear of postoperative meniscus: potential MR imaging signs. Radiology 1999;210(1):183-8.

[16] Trattnig S, Rand T, Czerny C, etal. Magnetic resonance imaging of the postoperative knee. Top Magn Reson Imaging 1999;10(4):221-36.

[17] McCauleyTR. MR imaging evaluation of the postoperative knee. Radiology 2005;234(1): 53-61.

[18] White LM, Schweitzer ME, Weishaupt D, et al. Diagnosis of recurrent meniscal tears: prospective evaluation of conventional MR imaging, indirect MR arthrography, and direct MR arthrography. Radiology 2002;222(2):421-9.

[19] Magee T, Shapiro M, Rodriguez J, et al. MR arthrography of postoperative knee: for which patients is it useful? Radiology 2003;229(1):159-63.

[20] Applegate GR, Flannigan BD, Tolin BS, et al. MR diagnosis of recurrent tears in the knee: value of intraarticular contrast material. AJR Am J Roentgenol 1993;161(4):821-5.

[21] van Trommel MF, Potter HG, Ernberg LA, etal. The use of noncontrast magnetic resonance imaging in evaluating meniscal repair: comparison with conventional arthrography. Arthroscopy 1998;14(1):2-8.

[22] Sciulli RL, Boutin RD, Brown RR, et al. Evaluation of the postoperative meniscus of the knee: a study comparing conventional arthrography, conventional MR imaging, MR arthrography with iodinated contrast material, and MR arthrography with gadolinium-based contrast material. Skeletal Radiol 1999;28(9):508-14.

[23] Vives MJ, Homesley D, Ciccotti MG, etal. Evaluation of recurring meniscal tears with gadolinium-enhanced magnetic resonance imaging: a randomized, prospective study. Am J Sports Med 2003;31(6):868-73.

[24] RechtMP, KramerJ. MR imaging of the postoperative knee: a pictorial essay. Radiographics 2002;22(4):765-74.

[25] Hantes ME, Zachos VC, Zibis AH, et al. Evaluation of meniscal repair with serial magnetic resonance imaging: a comparative study between conventional MRI and indirect MR arthrography. Eur J Radiol 2004;50(3):231-7.

[26] Mariani PP, Santori N, Adriani E, et al. Accelerated rehabilitation after arthroscopic meniscal repair: a clinical and magnetic resonance imaging evaluation. Arthroscopy 1996;12(6):680-6.

[27] White LM, KramerJ, RechtMP. MR imaging evaluation of the postoperative knee: ligaments, menisci, and articular cartilage. Skeletal Radiol 2005;34(8):431-52.

[28] Finsterbush A, Frankl U, Matan Y, etal. Secondary damage to the knee after isolated injury of the anterior cruciate ligament. Am J Sports Med 1990;18(5):475-9.

[29] Recht MP, Piraino DW, Applegate G, et al. Complications after anterior cruciate ligament reconstruction: radiographic and MR findings. AJR Am J Roentgenol 1996;167(3): 705-10.

[30] Ilaslan H, Sundaram M, Miniaci A. Imaging evaluation of the postoperative knee ligaments. Eur J Radiol 2005;54(2):178-88.

[31] SchatzJA, Potter HG, Rodeo SA, etal. MR imaging of anterior cruciate ligament reconstruction. AJR Am J Roentgenol 1997;169(1):223-8.

[32] White LM, Buckwalter KA. Technical considerations: CTand MR imaging in the postoperative orthopedic patient. Semin Musculoskelet Radiol 2002;6(1):5-17.

[33] Lajtai G, Noszian I, Humer K, etal. Serial magnetic resonance imaging evaluation of operative site after fixation of patellar tendon graft with bioabsorbable interference screws in anterior cruciate ligament reconstruction. Arthroscopy 1999;15(7):709-18.

[34] Amiel D, Kleiner JB, Roux RD, et al. The phenomenon of "ligamentization": anterior cruciate ligament reconstruction with autogenous patellar tendon. J Orthop Res 1986;4(2): 162-72.

[35] Jansson KA, Karjalainen PT, HarilainenA, etal. MRI ofanterior cruciate ligament repair with patellar and hamstring tendon autografts. Skeletal Radiol 2001;30(1):8-14.

[36] Stockle U, Hoffmann R, Schwedke J, et al. Anterior cruciate ligament reconstruction: the diagnostic value of MRI. Int Orthop 1998;22(5):288-92.

[37] Vogl TJ, Schmitt J, Lubrich J, etal. Reconstructed anterior cruciate ligaments using patellar tendon ligament grafts: diagnostic value of contrast-enhanced MRI in a 2-year follow-up regimen. Eur Radiol 2001;11(8):1450-6.

[38] Peterson RK, Shelton WR, Bomboy AL. Allograft versus autograft patellar tendon anterior cruciate ligament reconstruction: a 5-year follow-up. Arthroscopy 2001;17(1):9-13.

[39] Kartus J, Lindahl S, Stener S, etal. Magnetic resonance imaging of the patellar tendon after harvesting its central third: a comparison between traditional and subcutaneous harvesting techniques. Arthroscopy 1999;15(6):587-93.

[40] Murakami Y, Sumen Y, Ochi M, et al. MR evaluation of human anterior cruciate ligament autograft on oblique axial imaging. J Comput Assist Tomogr 1998;22(2):270-5.

[41] Sanders TG. MR imaging of postoperative ligaments of the knee. Semin Musculoskelet Radiol 2002;6(1):19-33.

[42] Rispoli DM, Sanders TG, Miller MD, etal. Magnetic resonance imaging at different time periods following hamstring harvest for anterior cruciate ligament reconstruction. Arthroscopy 2001;17(1):2-8.

[43] Tomczak RJ, Hehl G, Mergo PJ, et al. Tunnel placement in anterior cruciate ligament reconstruction: MRI analysis as an important factor in the radiological report. Skeletal Radiol 1997;26(7):409-13.

[44] Howell SM, Berns GS, Farley TE. Unimpinged and impinged anterior cruciate ligament grafts: MR signal intensity measurements. Radiology 1991;179(3):639-43.

[45] Howell SM, ClarkJA, Blasier RD. Serial magnetic resonance imaging of hamstring anterior cruciate ligament autografts during the first year of implantation. A preliminary study. Am J Sports Med 1991;19(1):42-7.

[46] Papakonstantinou O, Chung CB, Chanchairujira K, etal. Complications of anterior cruciate ligament reconstruction: MR imaging. Eur Radiol 2003;13(5):1 106-17.

[47] Howell SM. Arthroscopic roofplasty: a method for correcting an extension deficit caused by roof impingement of an anterior cruciate ligament graft. Arthroscopy 1992;8(3):375-9.

[48] May DA, Snearly WN, Bents R, et al. MR imaging findings in anterior cruciate ligament reconstruction: evaluation of notchplasty. AJR AmJ Roentgenol 1997;169(1):217-22.

[49] Horton LK, JacobsonJA, Lin J, etal. MR imaging of anterior cruciate ligament reconstruction graft. AJR Am J Roentgenol 2000;175(4):1091-7.

[50] McCauleyTR, Elfar A, Moore A, etal. MR arthrography of anterior cruciate ligament reconstruction grafts. AJR Am J Roentgenol 2003;181(5):1217-23.

[51] Recht MP, Piraino DW, Cohen MA, etal. Localized anterior arthrofibrosis (cyclops lesion) after reconstruction of the anterior cruciate ligament: MR imaging findings. AJR Am J Roentgenol 1995;165(2):383-5.

[52] Bradley DM, Bergman AG, Dillingham MF. MR imaging of cyclops lesions. AJR Am J Roentgenol 2000;174(3):719-26.

[53] Clatworthy MG, Annear P, Bulow JU, et al. Tunnel widening in anterior cruciate ligament reconstruction: a prospective evaluation of hamstring and patella tendon grafts. Knee Surg Sports Traumatol Arthrosc 1999;7(3):138-45.

[54] Sanders TG, Tall MA, Mulloy JP, et al. Fluid collections in the osseous tunnel during the first year after anterior cruciate ligament repair using an autologous hamstring graft: natural history and clinical correlation. J Comput Assist Tomogr 2002;26(4):617-21.

[55] Sonin AH, Fitzgerald SW, Friedman H, etal. Posterior cruciate ligament injury: MR imaging diagnosis and patterns of injury. Radiology 1994;190(2):455-8.

[56] ParolieJM, BergfeldJA. Long-term results of nonoperative treatment of isolated posterior cruciate ligament injuries in the athlete. Am J Sports Med 1986;14(1):35-8.

[57] St Pierre P, Miller MD. Posterior cruciate ligament injuries. Clin Sports Med 1999;18(1): 199-221.

[58] Sherman PM, Sanders TG, Morrison WB, et al. MR imaging of the posterior cruciate ligament graft: initial experience in 15 patients with clinical correlation. Radiology 2001;221(1):191-8.

[59] Mariani PP, Adriani E, Bellelli A, et al. Magnetic resonance imaging of tunnel placement in posterior cruciate ligament reconstruction. Arthroscopy 1999;15(7):733-40.

[60] Curl WW, Krome J, Gordon ES, et al. Cartilage injuries: a review of 31,516 knee arthroscopies. Arthroscopy 1997;13(4):456-60.

[61] Potter HG, LinklaterJM, Allen AA, et al. Magnetic resonance imaging of articular cartilage in the knee. An evaluation with use of fast-spin-echo imaging. J Bone Joint Surg Am 1998;80(9):1276-84.

[62] Bredella MA, Tirman PF, Peterfy CG, et al. Accuracy of T2-weighted fast spin-echo MR imaging with fat saturation in detecting cartilage defects in the knee: comparison with arthroscopy in 130 patients. AJR Am J Roentgenol 1999;172(4):1073-80.

[63] Disler DG, McCauley TR, Wirth CR, et al. Detection of knee hyaline cartilage defects using fat-suppressed three-dimensional spoiled gradient-echo MR imaging: comparison with standard MR imaging and correlation with arthroscopy. AJR Am J Roentgenol 1995;165(2): 377-82.

[64] Alparslan L, Winalski CS, Boutin RD, et al. Postoperative magnetic resonance imaging of articular cartilage repair. Semin Musculoskelet Radiol 2001;5(4):345-63.

[65] RechtM, White LM, Winalski CS, etal. MR imaging of cartilage repair procedures. Skeletal Radiol 2003;32(4):1 85-200.

[66] Sanders TG, Mentzer KD, Miller MD, et al. Autogenous osteochondral "plug" transfer for the treatment of focal chondral defects: postoperative MR appearance with clinical correlation. Skeletal Radiol 2001;30(10):570-8.

[67] Gold GE, Bergman AG, PaulyJM, et al. Magnetic resonance imaging of knee cartilage repair. Top Magn Reson Imaging 1998;9(6):377-92.

[68] Alparslan L, Minas T, Winalski CS. Magnetic resonance imaging of autologous chondrocyte implantation. Semin Ultrasound CT MR 2001;22(4):341-51.

I fi



I fi



Knee Ultrasound Stress Fractur

Was this article helpful?

0 0

Post a comment