Relevant traumatic injury of the knee joint-MRI follow-up after 7-10 years

To evaluate prospectively the history of relevant traumatic knee injuries at least 7 years after trauma by MRI focusing on the development of degenerative changes.

Seventeen patients without baseline degenerative changes had a follow-up knee MRI several years after relevant knee injury (interval baseline-follow-up was 9.1 years, S.D. +/-1.3 years). Relevant knee injury was defined as complete cruciate or collateral ligament rupture, traumatic meniscal tear or osteochondral injury. Baseline MRI examinations were evaluated for traumatic ligamentous, chondral, meniscal and osseous lesions. Follow-up MRIs were evaluated for ligamentous and meniscal status, articular surface and incidence of degenerative changes such as cartilage loss, osteophytes and bone marrow lesions.

Among the 11 patients who had a complete rupture of the ACL at baseline, 3 (27.3%) presented with cartilage loss. Among the eight patients who had suffered a post-traumatic meniscal tear at baseline, four (50%) presented with cartilage loss at follow-up. Among the five patients who had an osteochondral fracture at baseline, two (40%) presented with cartilage loss at follow-up imaging. Cartilage loss in all cases was observed adjacent to the subregions where meniscal damage and/or osteochondral incongruence was/were present at follow-up imaging.

We hypothesize that the post-traumatic or postsurgical meniscal damage and the persistence of an irregular articular surface may have played a role in the subsequent loss of cartilage in our patient population.