Quantitative Magnetic Resonance Imaging Assessment of Cartilage Status: A Comparison Between Young Men With and Without Anterior Cruciate Ligament Reconstruction


      To assess the cartilage status of the knee joints using magnetic resonance imaging at least 2 years after anterior cruciate ligament reconstruction (ACLR) in young adult men.


      Thirty young male patients with unilateral ACLR and 15 age-matched and body mass index–matched healthy men (controls) participated in this study. All participants underwent quantitative magnetic resonance imaging scans. Three-dimensional dual-echo steady-state sagittal images were segmented using solid model software to calculate the mean cartilage thickness, and multi-echo sagittal images were segmented with Siemens software (Siemens, Erlangen, Germany) to determine the T2 relaxation time of each cartilage plate.


      There was no statistically significant difference in the mean thickness of each cartilage plate between the ACLR and control groups (P = .9616 for lateral femoral cartilage, P = .5962 for lateral tibial cartilage, P = .9328 for patellar cartilage, P = .9712 for trochlear cartilage, P = .4408 for medial femoral cartilage, and P = .1933 for medial tibial cartilage). The ACLR group had significantly higher T2 values than the control group in the lateral femoral cartilage (P < .001), lateral tibia (P = .0011), trochlea (P = .0028), medial femur (P < .001), and medial tibia (P < .001). In addition, the patella showed no difference in T2 values between the 2 groups (P = .2152). The medial compartment cartilage showed a much higher percentage change in cartilage T2 values in the ACLR group.


      Although no difference in cartilage thickness was detected between the ACLR group and the control group, the mean T2 relaxation time in the ACLR patients was significantly longer than that in control subjects.

      Level of Evidence

      Level III, retrospective comparative study.
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        • Spindler K.P.
        • Wright R.W.
        Clinical practice. Anterior cruciate ligament tear.
        N Engl J Med. 2008; 359: 2135-2142
        • Von Porat A.
        • Roos E.M.
        • Roos H.
        High prevalence of osteoarthritis 14 years after an anterior cruciate ligament tear in male soccer players: A study of radiographic and patient relevant outcomes.
        Ann Rheum Dis. 2004; 63: 269-273
        • Lohmander L.S.
        • Ostenberg A.
        • Englund M.
        • Roos H.
        High prevalence of knee osteoarthritis, pain, and functional limitations in female soccer players twelve years after anterior cruciate ligament injury.
        Arthritis Rheum. 2004; 50: 3145-3152
        • Li G.
        • Moses J.M.
        • Papannagari R.
        • Pathare N.P.
        • DeFrate L.E.
        • Gill T.J.
        Anterior cruciate ligament deficiency alters the in vivo motion of the tibiofemoral cartilage contact points in both the anteroposterior and mediolateral directions.
        J Bone Joint Surg Am. 2006; 88: 1826-1834
        • Van de Velde S.K.
        • Bingham J.T.
        • Hosseini A.
        • et al.
        Increased tibiofemoral cartilage contact deformation in patients with anterior cruciate ligament deficiency.
        Arthritis Rheum. 2009; 60: 3693-3702
        • Siebold R.
        • Dehler C.
        • Ellert T.
        Prospective randomized comparison of double-bundle versus single-bundle anterior cruciate ligament reconstruction.
        Arthroscopy. 2008; 24: 137-145
        • Hui C.
        • Salmon L.J.
        • Kok A.
        • Maeno S.
        • Linklater J.
        • Pinczewski L.A.
        Fifteen-year outcome of endoscopic anterior cruciate ligament reconstruction with patellar tendon autograft for “isolated” anterior cruciate ligament tear.
        Am J Sports Med. 2011; 39: 89-98
        • Oiestad B.E.
        • Holm I.
        • Aune A.K.
        • et al.
        Knee function and prevalence of knee osteoarthritis after anterior cruciate ligament reconstruction: A prospective study with 10 to 15 years of follow-up.
        Am J Sports Med. 2010; 38: 2201-2210
        • Feller J.
        Anterior cruciate ligament rupture: Is osteoarthritis inevitable?.
        Br J Sports Med. 2004; 38: 383-384
        • Oiestad B.E.
        • Holm I.
        • Engebretsen L.
        • Risberg M.A.
        The association between radiographic knee osteoarthritis and knee symptoms, function and quality of life 10-15 years after anterior cruciate ligament reconstruction.
        Br J Sports Med. 2011; 45: 583-588
        • Eckstein F.
        • Cicuttini F.
        • Raynauld J.P.
        • Waterton J.C.
        • Peterfy C.
        Magnetic resonance imaging (MRI) of articular cartilage in knee osteoarthritis (OA): Morphological assessment.
        Osteoarthritis Cartilage. 2006; 14: A46-A75
        • Roemer F.W.
        • Eckstein F.
        • Guermazi A.
        Magnetic resonance imaging-based semiquantitative and quantitative assessment in osteoarthritis.
        Rheum Dis Clin North Am. 2009; 35: 521-555
        • Wang Y.X.
        • Griffith J.F.
        • Ahuja A.T.
        Non-invasive MRI assessment of the articular cartilage in clinical studies and experimental settings.
        World J Radiol. 2010; 2: 44-54
        • Faber S.C.
        • Eckstein F.
        • Lukasz S.
        • et al.
        Gender differences in knee joint cartilage thickness, volume and articular surface areas: Assessment with quantitative three-dimensional MR imaging.
        Skeletal Radiol. 2001; 30: 144-150
        • Otterness I.G.
        • Eckstein F.
        Women have thinner cartilage and smaller joint surfaces than men after adjustment for body height and weight.
        Osteoarthritis Cartilage. 2007; 15: 666-672
        • Ding C.
        • Cicuttini F.
        • Scott F.
        • Cooley H.
        • Jones G.
        Association between age and knee structural change: A cross sectional MRI based study.
        Ann Rheum Dis. 2005; 64: 549-555
        • Ding C.
        • Cicuttini F.
        • Scott F.
        • Cooley H.
        • Jones G.
        Knee structural alteration and BMI: A cross-sectional study.
        Obes Res. 2005; 13: 350-361
        • Boocock M.
        • McNair P.
        • Cicuttini F.
        • Stuart A.
        • Sinclair T.
        The short-term effects of running on the deformation of knee articular cartilage and its relationship to biomechanical loads at the knee.
        Osteoarthritis Cartilage. 2009; 17: 883-890
        • Mosher T.J.
        • Dardzinski B.J.
        Cartilage MRI T2 relaxation time mapping: Overview and applications.
        Semin Musculoskelet Radiol. 2004; 8: 355-368
        • Dunn T.C.
        • Lu Y.
        • Jin H.
        • Ries M.D.
        • Majumdar S.
        T2 relaxation time of cartilage at MR imaging: Comparison with severity of knee osteoarthritis.
        Radiology. 2004; 232: 592-598
        • Bining H.J.
        • Santos R.
        • Andrews G.
        • Forster B.B.
        Can T2 relaxation values and color maps be used to detect chondral damage utilizing subchondral bone marrow edema as a marker?.
        Skeletal Radiol. 2009; 38: 459-465
        • Pan J.
        • Pialat J.B.
        • Joseph T.
        • et al.
        Knee cartilage T2 characteristics and evolution in relation to morphologic abnormalities detected at 3-T MR imaging: A longitudinal study of the normal control cohort from the Osteoarthritis Initiative.
        Radiology. 2011; 261: 507-515
        • Wan L.
        • de Asla R.J.
        • Rubash H.E.
        • Li G.
        In vivo cartilage contact deformation of human ankle joints under full body weight.
        J Orthop Res. 2008; 26: 1081-1089
        • Ahn J.H.
        • Lee S.H.
        • Choi S.H.
        • Lim T.K.
        Magnetic resonance imaging evaluation of anterior cruciate ligament reconstruction using quadrupled hamstring tendon autografts: Comparison of remnant bundle preservation and standard technique.
        Am J Sports Med. 2010; 38: 1768-1777
        • Blumenkrantz G.
        • Stahl R.
        • Carballido-Gamio J.
        • et al.
        The feasibility of characterizing the spatial distribution of cartilage T(2) using texture analysis.
        Osteoarthritis Cartilage. 2008; 16: 584-590
        • Frobell R.B.
        Change in cartilage thickness, posttraumatic bone marrow lesions, and joint fluid volumes after acute ACL disruption: A two-year prospective MRI study of sixty-one subjects.
        J Bone Joint Surg Am. 2011; 93: 1096-1103
        • Andreisek G.
        • White L.M.
        • Sussman M.S.
        • et al.
        Quantitative MR imaging evaluation of the cartilage thickness and subchondral bone area in patients with ACL-reconstructions 7 years after surgery.
        Osteoarthritis Cartilage. 2009; 17: 871-878
        • Li H.
        • Hosseini A.
        • Li J.
        • Gill T.J.
        • Li G.
        Quantitative magnetic resonance imaging (MRI) morphological analysis of knee cartilage in healthy and anterior cruciate ligament-injured knees.
        Knee Surg Sports Traumatol Arthrosc. 2012; 20: 1496-1502
        • Cotofana S.
        • Eckstein F.
        • Wirth W.
        • et al.
        In vivo measures of cartilage deformation: Patterns in healthy and osteoarthritic female knees using 3T MR imaging.
        Eur Radiol. 2011; 21: 1127-1135
        • Gold G.E.
        • Chen C.A.
        • Koo S.
        • Hargreaves B.A.
        • Bangerter N.K.
        Recent advances in MRI of articular cartilage.
        AJR Am J Roentgenol. 2009; 193: 628-638
        • Nishii T.
        • Kuroda K.
        • Matsuoka Y.
        • Sahara T.
        • Yoshikawa H.
        Change in knee cartilage T2 in response to mechanical loading.
        J Magn Reson Imaging. 2008; 28: 175-180
        • Luke A.C.
        • Stehling C.
        • Stahl R.
        • et al.
        High-field magnetic resonance imaging assessment of articular cartilage before and after marathon running: Does long-distance running lead to cartilage damage?.
        Am J Sports Med. 2010; 38: 2273-2280
        • Li X.
        • Kuo D.
        • Theologis A.
        • et al.
        Cartilage in anterior cruciate ligament-reconstructed knees: MR imaging T1{rho} and T2—Initial experience with 1-year follow-up.
        Radiology. 2011; 258: 505-514
        • Potter H.G.
        • Jain S.K.
        • Ma Y.
        • Black B.R.
        • Fung S.
        • Lyman S.
        Cartilage injury after acute, isolated anterior cruciate ligament tear: Immediate and longitudinal effect with clinical/MRI follow-up.
        Am J Sports Med. 2012; 40: 276-285
        • Taylor C.
        • Carballido-Gamio J.
        • Majumdar S.
        • Li X.
        Comparison of quantitative imaging of cartilage for osteoarthritis: T2, T1rho, dGEMRIC and contrast-enhanced computed tomography.
        Magn Reson Imaging. 2009; 27: 779-784