E1165. 2D and 3D MR Imaging-Aid to Knee Preservation Surgery: Focus on Meniscus and Cartilage
  1. Atul Taneja; Hospital Israelita Albert Einstein; UT Southwestern
  2. Avneesh Chhabra; UT Southwestern
This presentation reviews the current literature and authors’ experience on imaging concepts and high-resolution 2D and 3D MR imaging techniques as they relate to management and planning for knee restorative procedures. Meniscus and cartilage specific reconstructions will be shown along with relevant arthroscopy correlations.

Educational Goals / Teaching Points
With increasing life expectancy of global human population, there is a growing demand for preservation of native articular meniscus and cartilage to delay joint arthroplasties, especially in younger and active patients. Since damage to the meniscus and hyaline cartilage of the knee have limited intrinsic capacity to heal, such lesions lead to premature and/or accelerated osteoarthritis. However, the knee surgical treatments have evolved and may allow restoration of the natural anatomy, delay progression of damage, and alter the biology of the meniscus and articular cartilage. The knee preservation surgery is aided by timely detection of such injuries and high-resolution illustration and characterization of the pathology using 2-dimensional and 3-dimensional magnetic resonance imaging (MRI), made possible due to better MR scanner technology and related software improvements.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
MR imaging is the modality of choice for noninvasive evaluation of meniscal and cartilage injuries and postoperative assessment following knee preservation surgery. 3D-MRI allows superior multiplanar resolution and fluid-contrast as compared to 2D-MRI and minimizes partial volume artifacts. Recent improvements in technology, such as sparse K-space sampling and deep learning method have shown increased time efficiency for MRI with preserved resolution.

Magnetic resonance imaging remains the imaging modality of choice for the evaluation of meniscus and articular cartilage injury. Timely and accurate detection and detailed characterization of lesions involving these structures is necessary to guide appropriate therapy, especially for knee preservation surgery. Newer MRI technological improvements using higher field magnets, accelerated imaging techniques, and 3D isotropic spin-echo imaging sequences have shown considerable promise in improved preoperative and postoperative assessment of knee derangements.