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Postoperative Meniscus: Assessment at Dual–Detector Row Spiral CT Arthrography of the Knee¹

¹ From the Departments of Radiology (C.M., B.C.V.B., F.E.L., B.M., J.M.) and Orthopedic Surgery (P.P., J.E.D.), Cliniques universitaires St Luc, Université Catholique de Louvain, 10 av Hippocrate, 1200 Brussels, Belgium. Received May 17, 2002; revision requested July 12; final revision received November 27; accepted January 14, 2003. Address correspondence to B.C.V.B. (e-mail: vandeberg@rdgn.ucl.ac.be).

PURPOSE: To assess the effectiveness of dual–detector row spiral computed tomographic (CT) arthrography of the knee in the evaluation of the postoperative meniscus for recurrent or residual meniscal tear.

MATERIALS AND METHODS: Spiral CT arthrography was performed in 20 patients who presented with pain after partial meniscectomy. Findings at the initial reading of the images and at two retrospective independent readings were compared with those at second-look arthroscopy performed in all patients. At initial interpretation, conventional criteria for meniscal tear were used, including partial- or full-thickness tear of any size and meniscal separation. At retrospective interpretation, criteria for meniscal tear included large partial- and full-thickness tear and meniscal separation but not small partial-thickness tear. Sensitivity and specificity for the detection of tear of the postoperative menisci were calculated for initial and retrospective readings.

RESULTS: At initial interpretation, the sensitivity and specificity for the detection of tear of the postoperative menisci were 100% and 78%, respectively. At retrospective interpretation, the sensitivity and specificity for the detection of tear of the postoperative menisci were 79% and 89% at reading 1 and 93% and 89% at reading 2, respectively.

CONCLUSION: Spiral CT arthrography is valuable for the assessment of postoperative menisci, but the application of conventional definitions of meniscal tear to arthrographic findings in postoperative menisci can lead to overestimation of the clinical importance of meniscal lesions.

© RSNA, 2003

Index terms: Knee, CT, 452.12115 • Knee, ligaments, menisci, and cartilage, 452.4852

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