The Postoperative Meniscus: Anatomical, Operative, and Imaging Considerations

Abstract

Meniscal surgery is commonplace. Patients who have had prior surgery may return for additional imaging for continued or new pain, limited range of motion, or interval injury. Accurate interpretation of postoperative imaging requires a clear understanding of the normal meniscal anatomy and biomechanics. Surgical goals and current surgical techniques impact the imaging appearance. These techniques are reviewed in the context of the various meniscal tear patterns. Multiple imaging modalities may be used in patient assessment with magnetic resonance (MR) imaging providing key information regarding the integrity of the meniscal repair. Imagers need to be aware of the key findings for a normal versus pathologic appearance to the postoperative meniscus as well as other potential MR findings that may account for patient presentation.

Assessment of Knee Menisci in Healthy Adults Using Shear Wave Elastography

“…They provide joint stability and cushioning, thereby protecting the cartilage and subchondral bone. 1 Due to the meniscus' limited healing capacity, early and accurate identification of meniscal injuries is important to prevent and treat degenerative knee osteoarthritis effectively.…”

“…The menisci are semi‐circular fibro‐cartilaginous structures that cover the medial and lateral tibial plateau, playing a crucial role in load transmission and pressure distribution during dynamic motion. They provide joint stability and cushioning, thereby protecting the cartilage and subchondral bone 1 . Due to the meniscus' limited healing capacity, early and accurate identification of meniscal injuries is important to prevent and treat degenerative knee osteoarthritis effectively.…”

Postoperative Knee and Shoulder

“…A tear in a new location (if a preoperative MR is available to show the original tear location), displaced meniscal fragments, or a fluidfilled cleft extending into the meniscus on a T2-weighted image remain reliable but insensitive signs of a recurrent meniscal tear, even when greater than 25% of the meniscus is removed (Fig. 9.4) [44,45]. Primary repair using suture, darts, or other anchors is the preferred treatment for menisci that have the potential to heal.…”

Magnetic Resonance Imaging Compared to Magnetic Resonance Arthrography in Assessment of Recurrent Meniscal Injury

“…Pain is usually the major cause of surgery, and it is also considered to be a critical post-operative complication (2,3) . The main purpose of meniscal surgery is to return the studied case to full function without pain (4) . The decision to perform either meniscectomy (partial or complete) or meniscal repair accounts for various factors such as the patient's years old & general condition, the extent & severity of the injury, and probability of success (5) .…”