Magnetic Resonance Imaging T2 Relaxation Times of Articular Cartilage Before and After Arthroscopic Surgery for Discoid Lateral Meniscus

Published:September 30, 2020DOI:


      To quantitatively evaluate degeneration of articular cartilage using magnetic resonance imaging (MRI) T2 mapping before and after arthroscopic surgery for discoid lateral meniscus (DLM).


      We retrospectively reviewed the medical records of patients who underwent arthroscopic reshaping surgery for symptomatic DLM from September 2013 to October 2017 and who had undergone follow-up for ≥2 years. MRI T2 relaxation examinations had been performed preoperatively and at 3, 6, 12, and 24 months postoperatively. The T2 relaxation times of the whole lateral femoral condyle and the tibial plateau were assessed. In addition, the lateral femoral condyle was divided into 3 subcompartmental areas: anterior, middle, and posterior.


      In total, 30 knees of 27 patients were included in this study. The patients’ mean age at operation was 13.3 years (range 6-23 years), and the mean follow-up period was 31.6 months. Saucerization alone was performed in 3 knees and saucerization with repair in 27 knees. The T2 relaxation time of the whole lateral femoral condyle was significantly increased at 3 and 6 months postoperatively and significantly decreased at 12 and 24 months. The T2 relaxation time of the whole lateral tibial plateau was significantly increased at 3 months postoperatively and significantly decreased at 24 months. The T2 relaxation time of the posterior subcompartment of the lateral femoral condyle was significantly increased at 3 months and significantly decreased at 12 and 24 months.


      The T2 relaxation time of the lateral femorotibial joint cartilage increased at 3 and 6 months postoperatively and then had decreased at 12 and 24 months. Quantitative MRI allowed us to monitor the substantial changes in the cartilage during the early postoperative period and the recovery at the distant time point after reshaping surgery for DLM.

      Level of Evidence

      Level IV, case series
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Arthroscopy
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Young R.B.
        The external semilunar cartilage as a complete disc.
        in: Cleland J. Mackay J.Y. Young R.B. Memoirs and memoranda in anatomy. Williams and Norgate, London, UK1889: 179
        • Papadopoulos A.
        • Kirkos J.M.
        • Kapetanos G.A.
        Histomorphologic study of discoid meniscus.
        Arthroscopy. 2009; 25: 262-268
        • Habata T.
        • Uematsu K.
        • Kasanami R.
        • et al.
        Long-term clinical and radiographic follow-up of total resection for discoid lateral meniscus.
        Arthroscopy. 2006; 22: 1339-1343
        • Ikeuchi H.
        Arthroscopic treatment of the discoid lateral meniscus: Technique and long-term results.
        Clin Orthop Relat Res. 1982; 167: 19-28
        • Okazaki K.
        • Miura H.
        • Matsuda S.
        • Hashizume M.
        • Iwamoto Y.
        Arthroscopic resection of the discoid lateral meniscus: long-term follow-up for 16 years.
        Arthroscopy. 2006; 22: 967-971
        • Abdon P.
        • Turner M.S.
        • Pettersson H.
        • Lindstrand A.
        • Stenstrom A.
        • Swanson A.J.
        A long-term follow-up study of total meniscectomy in children.
        Clin Orthop Relat Res. 1990; 257: 166-170
        • Manzione M.
        • Pizzutillo P.D.
        • Peoples A.B.
        • Schweizer P.A.
        Meniscectomy in children: a long-term follow-up study.
        Am J Sports Med. 1983; 11: 111-115
        • Fujikawa K.
        • Iseki F.
        • Mikura Y.
        Partial resection of the discoid meniscus in the child’s knee.
        J Bone Joint Surg Br. 1981; 63: 391-395
        • Ogut T.
        • Kesmezacar H.
        • Akgun I.
        • Cansu E.
        Arthroscopic meniscectomy for discoid lateral meniscus in children and adolescents: 4.5 year follow-up.
        J Pediatr Orthop B. 2003; 12: 390-397
        • Adachi N.
        • Ochi M.
        • Uchio Y.
        • Kuriwaka M.
        • Shinomiya R.
        Torn discoid lateral meniscus treated using partial central meniscectomy and suture of the peripheral tear.
        Arthroscopy. 2004; 20: 536-542
        • Ahn J.H.
        • Kim K.I.
        • Wang J.H.
        • Jeon J.W.
        • Cho Y.C.
        • Lee S.H.
        Long-term results of arthroscopic reshaping for symptomatic discoid lateral meniscus in children.
        Arthroscopy. 2015; 31: 867-873
        • Ahn J.H.
        • Lee S.H.
        • Yoo J.C.
        • Lee Y.S.
        • Ha H.C.
        Arthroscopic partial meniscectomy with repair of the peripheral tear for symptomatic discoid lateral meniscus in children: results of minimum 2 years of follow-up.
        Arthroscopy. 2008; 24: 888-898
        • Carter C.W.
        • Hoellwarth J.
        • Weiss J.M.
        Clinical outcomes as a function of meniscal stability in the discoid meniscus: a preliminary report.
        J Pediatr Orthop. 2012; 32: 9-14
        • Good C.R.
        • Green D.W.
        • Griffith M.H.
        • Valen A.W.
        • Widmann R.F.
        • Rodeo S.A.
        Arthroscopic treatment of symptomatic discoid meniscus in children: classification, technique, and results.
        Arthroscopy. 2007; 23: 157-163
        • Wasser L.
        • Knorr J.
        • Accadbled F.
        • Abid A.
        • Sales De Gauzy J.
        Arthroscopic treatment of discoid meniscus in children: clinical and MRI results.
        Orthop Traumatol Surg Res. 2011; 97: 297-303
        • Kim S.J.
        • Chun Y.M.
        • Jeong J.H.
        • Ryu S.W.
        • Oh K.S.
        • Lubis A.M.
        Effects of arthroscopic meniscectomy on the long-term prognosis for the discoid lateral meniscus.
        Knee Surg Sports Traumatol Arthrosc. 2007; 15: 1315-1320
        • Lee D.H.
        • Kim T.H.
        • Kim J.M.
        • Bin S.I.
        Results of subtotal/total or partial meniscectomy for discoid lateral meniscus in children.
        Arthroscopy. 2009; 25: 496-503
        • Ahn J.H.
        • Kang D.M.
        • Choi K.J.
        Risk factors for radiographic progression of osteoarthritis after partial meniscectomy of discoid lateral meniscus tear.
        Orthop Traumatol Surg Res. 2017; 103: 1183-1188
        • Yamasaki S.
        • Hashimoto Y.
        • Takigami J.
        • Terai S.
        • Takahashi S.
        • Nakamura H.
        Risk factors associated with knee joint degeneration after arthroscopic reshaping for juvenile discoid lateral meniscus.
        Am J Sports Med. 2017; 45: 570-577
        • Nieminen M.T.
        • Rieppo J.
        • Töyräs J.
        • et al.
        T2 relaxation reveals spatial collagen architecture in articular cartilage; a comparative quantitative MRI and polarized light microscopic study.
        Magn Reson Med. 2001; 46: 487-493
        • Liess C.
        • Lüsse S.
        • Karger N.
        • Heller M.
        • Glüer C.C.
        Detection of changes in cartilage water content using MRI T2 mapping in vivo.
        Osteoarthritis Cartilage. 2002; 10: 907-913
        • Kijowski R.
        • Blankenbaker D.G.
        • Munoz Del Rio A.
        • Baer G.S.
        • Graf B.K.
        Evaluation of the articular cartilage of the knee joint: Value of adding a T2 mapping sequence to a routine MR imaging protocol.
        Radiology. 2013; 267: 503-513
        • Murakami K.
        • Arai Y.
        • Ikoma K.
        • et al.
        Total resection of any segment of the lateral meniscus may cause early cartilage degeneration: Evaluation by magnetic resonance imaging using T2 mapping.
        Medicine (Baltimore). 2018; 97e11011
        • Kato K.
        • Arai Y.
        • Ikoma K.
        • et al.
        Early postoperative cartilage evaluation by magnetic resonance imaging using T2 mapping after arthroscopic partial medial meniscectomy.
        Magn Reson Imaging. 2015; 33: 1274-1280
        • Samoto N.
        • Kozuma M.
        • Tokuhisa T.
        • Kobayashi K.
        Diagnosis of discoid lateral meniscus of the knee on MR imaging.
        Magn Reson Imaging. 2002; 20: 59-64
        • Sang-Hee Choi
        • Kyung Eun Shin
        • Moon Jong Chang
        • Sook Young Woo
        • Sang Hak Lee
        Diagnostic criterion to distinguish between incomplete and complete discoid lateral meniscus on MRI.
        J Magn Reson Imaging. 2013; 38: 417-421
        • Harris J.D.
        • Brand J.C.
        • Cote M.P.
        • Faucett S.C.
        • Dhawan A.
        Research pearls: The significance of statistics and perils of pooling. Part 1: Clinical versus statistical significance.
        Arthroscopy. 2017; 33: 1102-1112
        • Bolbos R.I.
        • Link T.M.
        • Ma C.B.
        • Majumdar S.
        • Li X.
        T1rho relaxation time of the meniscus and its relationship with T1rho of adjacent cartilage in knees with acute ACL injuries at 3 T.
        Osteoarthritis Cartilage. 2009; 17: 12-18
        • Kim H.K.
        • Shiraj S.
        • Anton C.G.
        • Horn P.S.
        • Dardzinski B.J.
        Age and sex dependency of cartilage T2 relaxation time mapping in MRI of children and adolescents.
        AJR Am J Roentgenol. 2014; 202: 626-632
        • Matsuo T.
        • Kinugasa K.
        • Sakata K.
        • Ohori T.
        • Mae T.
        • Hamada M.
        Post-operative deformation and extrusion of the discoid lateral meniscus following a partial meniscectomy with repair.
        Knee Surg Sports Traumatol Arthrosc. 2017; 25: 390-396
        • Yoo W.J.
        • Jang W.Y.
        • Park M.S.
        • Chung C.Y.
        • Cheon J.E.
        • Cho T.J.
        • Choi I.H.
        Arthroscopic treatment for symptomatic discoid meniscus in children: Midterm outcomes and prognostic factors.
        Arthroscopy. 2015; 31: 2327-2334
        • Lee Y.S.
        • Teo S.H.
        • Ahn J.H.
        • et al.
        Systematic review of the long-term surgical outcomes of discoid lateral meniscus.
        Arthroscopy. 2017; 33: 1884-1895
        • Hashimoto Y.
        • Nishino K.
        • Reid 3rd, J.B.
        • et al.
        Factors related to postoperative osteochondritis dissecans of the lateral femoral condyle after meniscal surgery in juvenile patients with a discoid lateral meniscus.
        J Pediatr Orthop. 2020; 40: e853-e859
        • Li H.
        • Chen S.
        • Tao H.
        • Chen S.
        Quantitative MRI T2 relaxation time evaluation of knee cartilage: comparison of meniscus-intact and -injured knees after anterior cruciate ligament reconstruction.
        Am J Sports Med. 2015; 43: 865-872
        • Bolbos R.I.
        • Zuo J.
        • Banerjee S.
        • et al.
        Relationship between trabecular bone structure and articular cartilage morphology and relaxation times in early OA of the knee joint using parallel MRI at 3 T.
        Osteoarthritis Cartilage. 2008; 16: 1150-1159
        • Cağlar E.1
        • Şahin G.
        • Oğur T.
        • Aktaş E.
        Quantitative evaluation of hyaline articular cartilage T2 maps of knee and determine the relationship of cartilage T2 values with age, gender, articular changes.
        Eur Rev Med Pharmacol Sci. 2014; 18: 3386-3393
        • Zarins Z.A.
        • Bolbos R.I.
        • Pialat J.B.
        • et al.
        Cartilage and meniscus assessment using T1rho and T2 measurements in healthy subjects and patients with osteoarthritis.
        Osteoarthritis Cartilage. 2010; 18: 1408-1416
        • Mars M.
        • Chelli M.
        • Tbini Z.
        • Ladeb F.
        • Gharbi S.
        MRI T2 mapping of knee articular cartilage using different acquisition sequences and calculation methods at 1.5 Tesla.
        Med Princ Pract. 2018; 27: 443-450
        • Souza R.B.
        • Wu S.J.
        • Morse L.J.
        • Subburaj K.
        • Allen C.R.
        • Feeley B.T.
        Cartilage MRI relaxation times after arthroscopic partial medial meniscectomy reveal localized degeneration.
        Knee Surg Sports Traumatol Arthrosc. 2015; 23: 188-197
        • Chen M.
        • Qiu L.
        • Shen S.
        • Wang F.
        • Zhang J.
        • Zhang C.
        • Liu S.
        The influences of walking, running and stair activity on knee articular cartilage: Quantitative MRI using T1 rho and T2 mapping.
        PLoS One. 2017; 12e0187008
        • Bydder M.1
        • Rahal A.
        • Fullerton G.D.
        • Bydder G.M.
        The magic angle effect: a source of artifact, determinant of image contrast, and technique for imaging.
        J Magn Reson Imaging. 2007; 25: 290-300
        • Mizuta H.1
        • Nakamura E.
        • Otsuka Y.
        • Kudo S.
        • Takagi K.
        Osteochondritis dissecans of the lateral femoral condyle following total resection of the discoid lateral meniscus.
        Arthroscopy. 2001; 17: 608-612
        • Nguyen J.C.
        • Allen H.
        • Liu F.
        • Woo K.M.
        • Zhou Z.
        • Kijowski R.
        Maturation-related changes in t2 relaxation times of cartilage and meniscus of the pediatric knee joint at 3 T.
        AJR Am J Roentgenol. 2018; 211: 1369-1375