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Longitudinal Quantitative Mapping of Meniscal Morphological and Signal Intensity Differences After ACL Surgery
Dominique A Barnes1,2, Crystal J Murray1,2, Mohammadreza Movahhedi3
1Department of Orthopaedics, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
The American Journal of Sports Medicine
|August 11, 2026
Summary
Meniscal changes after anterior cruciate ligament (ACL) surgery persist for at least two years, impacting joint recovery. Quantitative MRI reveals persistent alterations in meniscal size and signal intensity, highlighting the need for location-specific analysis.
Area of Science:
- Orthopedic surgery
- Radiology
- Sports medicine
Background:
- Meniscal tears often accompany anterior cruciate ligament (ACL) injuries.
- Assessing longitudinal meniscal changes post-ACL surgery is crucial for understanding joint recovery and reinjury risk.
Purpose of the Study:
- To evaluate longitudinal changes in meniscal cross-sectional area (CSA) and signal intensity (SI) after ACL surgery.
- To compare meniscal morphology between surgical and contralateral knees at 6, 12, and 24 months post-surgery.
Main Methods:
- A cohort study analyzed deidentified postoperative Constructive Interference in Steady State (CISS) MRI scans from 82 patients (57 ACL restoration, 25 ACL reconstruction).
- Quantitative MRI assessed meniscal CSA and normalized CISS SI to create morphological profiles.
- Statistical parametric mapping compared surgical and contralateral limbs to identify regional differences at 6, 12, and 24 months.
Main Results:
- Surgical knees showed greater anterior medial and lateral meniscal CSA and SI compared to contralateral knees at all time points.
- The posterior medial meniscus CSA was smaller in surgical knees.
- Meniscal profiles at 24 months did not return to contralateral limb levels.
Conclusions:
- Significant meniscal alterations persist for at least 2 years after ACL surgery.
- Anatomic location is critical when evaluating meniscal morphology and the effects of ACL injury on surrounding tissues.
