Nishino Kazuya, Hashimoto Yusuke, Nishida Yohei, Yamasaki Shinya, Nakamura Hiroaki
Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
Arthroscopy. 2021 Feb;37(2):647-654. doi: 10.1016/j.arthro.2020.09.036. Epub 2020 Sep 30.
To quantitatively evaluate degeneration of articular cartilage using magnetic resonance imaging (MRI) T2 mapping before and after arthroscopic surgery for discoid lateral meniscus (DLM).
We retrospectively reviewed the medical records of patients who underwent arthroscopic reshaping surgery for symptomatic DLM from September 2013 to October 2017 and who had undergone follow-up for ≥2 years. MRI T2 relaxation examinations had been performed preoperatively and at 3, 6, 12, and 24 months postoperatively. The T2 relaxation times of the whole lateral femoral condyle and the tibial plateau were assessed. In addition, the lateral femoral condyle was divided into 3 subcompartmental areas: anterior, middle, and posterior.
In total, 30 knees of 27 patients were included in this study. The patients' mean age at operation was 13.3 years (range 6-23 years), and the mean follow-up period was 31.6 months. Saucerization alone was performed in 3 knees and saucerization with repair in 27 knees. The T2 relaxation time of the whole lateral femoral condyle was significantly increased at 3 and 6 months postoperatively and significantly decreased at 12 and 24 months. The T2 relaxation time of the whole lateral tibial plateau was significantly increased at 3 months postoperatively and significantly decreased at 24 months. The T2 relaxation time of the posterior subcompartment of the lateral femoral condyle was significantly increased at 3 months and significantly decreased at 12 and 24 months.
The T2 relaxation time of the lateral femorotibial joint cartilage increased at 3 and 6 months postoperatively and then had decreased at 12 and 24 months. Quantitative MRI allowed us to monitor the substantial changes in the cartilage during the early postoperative period and the recovery at the distant time point after reshaping surgery for DLM.
Level IV, case series.
使用磁共振成像（MRI）T2 映射定量评估盘状外侧半月板（DLM）关节镜手术前后关节软骨的退变情况。
我们回顾性分析了 2013 年 9 月至 2017 年 10 月因症状性 DLM 接受关节镜重塑手术且随访时间≥2 年的患者的病历。术前及术后 3、6、12 和 24 个月进行了 MRI T2 弛豫检查。评估了整个外侧股骨髁和胫骨平台的 T2 弛豫时间。此外，将外侧股骨髁分为 3 个亚区域：前部、中部和后部。
本研究共纳入 27 例患者的 30 个膝关节。患者手术时的平均年龄为 13.3 岁（范围 6 - 23 岁），平均随访期为 31.6 个月。仅行盘状化手术的有 3 个膝关节，行盘状化加修复手术的有 27 个膝关节。术后 3 个月和 6 个月时，整个外侧股骨髁的 T2 弛豫时间显著增加，术后 12 个月和 24 个月时显著降低。术后 3 个月时，整个外侧胫骨平台的 T2 弛豫时间显著增加，术后 24 个月时显著降低。外侧股骨髁后部亚区域的 T2 弛豫时间在术后 3 个月时显著增加，术后 12 个月和 24 个月时显著降低。
外侧股胫关节软骨的 T2 弛豫时间在术后 3 个月和 6 个月时增加，然后在术后 12 个月和 24 个月时降低。定量 MRI 使我们能够监测 DLM 重塑手术后早期软骨的实质性变化以及远期时间点的恢复情况。
IV 级，病例系列。
