The use of noncontrast magnetic resonance imaging in evaluating meniscal repair: comparison with conventional arthrography.

The objective of this study was to investigate whether new and different specialized fast spin-echo techniques could be used to accentuate signal within the site of meniscal repair, obviating the need for intra-articular contrast. With the use of the frequency-selective fat suppression technique, we were able to accentuate fluid in the repair site because of the inherent extended dynamic contrast range of the technique. We performed a blinded study to correlate specialized magnetic resonance imaging (MRI) sequences with standard contrast arthrography, which was used as a standard of reference. Thirty-six patients (36 meniscal repairs) agreed to have MRI followed by contrast arthrography of the affected knee, irrespective of their clinical symptoms. We found that MRI had a very high correlation with arthrography in assessing meniscal repair, with statistical significance. In eight cases that had a second-look arthroscopy, we were able to see that MRI proved to be more accurate than arthrography in discriminating partial or complete healing. This is the first report to show that specialized noncontrast MRI sequences are more effective in evaluating the physiological state of the repaired meniscus, without artifactual distention of the joint recesses by contrast and air. Noncontrast MRI can obviate the need for arthrography in assessment of meniscal repair.