Skip to main content

Advertisement

SpringerLink
Log in

Subclinical cartilage degeneration in young athletes with posterior cruciate ligament injuries detected with T1ρ magnetic resonance imaging mapping

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Prediction of the risk of osteoarthritis in asymptomatic active patients with an isolated injury of the posterior cruciate ligament (PCL) is difficult. T1ρ magnetic resonance imaging (MRI) enables the quantification of the proteoglycan content in the articular cartilage. The purpose of this study was to evaluate subclinical cartilage degeneration in asymptomatic young athletes with chronic PCL deficiency using T1ρ MRI.

Methods

Six athletes with chronic PCL deficiency (median age 17, range 14–36 years) and six subjects without any history of knee injury (median age 31.5, range 24–33 years) were recruited. Regions of interest were placed on the articular cartilage of the tibia and the distal and posterior areas of the femoral condyle, and T1ρ values were calculated.

Results

On stress radiographs, the mean side-to-side difference in posterior laxity was 9.8 mm. The T1ρ values at the posterior area of the lateral femoral condyle and the superficial layer of the distal area of the medial and lateral femoral condyle of the patients were significantly increased compared with those of the normal controls (p < 0.05). At the tibial plateau, the T1ρ values in both the medial and lateral compartments were significantly higher in patients compared with those in the normal controls (p < 0.05).

Conclusion

T1ρ MRI detected unexpected cartilage degeneration in the well-functioning PCL-deficient knees of young athletes. One should be alert to the possibility of subclinical cartilage degeneration even in asymptomatic patients who show no degenerative changes on plain radiographs or conventional MRI.

Level of evidence

IV.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Bolbos RI, Link TM, Ma CB, Majumdar S, Li X (2009) 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 17(1):12–18

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Boynton MD, Tietjens BR (1996) Long-term followup of the untreated isolated posterior cruciate ligament-deficient knee. Am J Sports Med 24(3):306–310

    Article  CAS  PubMed  Google Scholar 

  3. Colvin AC, Meislin RJ (2009) Posterior cruciate ligament injuries in the athlete: diagnosis and treatment. Bull NYU Hosp Jt Dis 67(1):45–51

    PubMed  Google Scholar 

  4. Crema MD, Roemer FW, Marra MD, Burstein D, Gold GE, Eckstein F, Baum T, Mosher TJ, Carrino JA, Guermazi A (2011) Articular cartilage in the knee: current MR imaging techniques and applications in clinical practice and research. Radiographics 31(1):37–61

    Article  PubMed  Google Scholar 

  5. Dijkgraaf LC, de Bont LG, Boering G, Liem RS (1995) The structure, biochemistry, and metabolism of osteoarthritic cartilage: a review of the literature. J Oral Maxillofac Surg 53(10):1182–1192

    Article  CAS  PubMed  Google Scholar 

  6. Fanelli GC, Beck JD, Edson CJ (2010) Current concepts review: the posterior cruciate ligament. J Knee Surg 23(2):61–72

    Article  PubMed  Google Scholar 

  7. Fowler PJ, Messieh SS (1987) Isolated posterior cruciate ligament injuries in athletes. Am J Sports Med 15(6):553–557

    Article  CAS  PubMed  Google Scholar 

  8. Jazrawi LM, Alaia MJ, Chang G, Fitzgerald EF, Recht MP (2011) Advances in magnetic resonance imaging of articular cartilage. J Am Acad Orthop Surg 19(7):420–429

    PubMed  Google Scholar 

  9. Hirose J, Nishioka H, Okamoto N, Oniki Y, Nakamura E, Yamashita Y, Usuku K, Mizuta H (2013) Articular cartilage lesions increase early cartilage degeneration in knees treated by anterior cruciate ligament reconstruction: T1rho mapping evaluation and 1-year follow-up. Am J Sports Med 41(10):2353–2361

    Article  PubMed  Google Scholar 

  10. Keller PM, Shelbourne KD, McCarroll JR, Rettig AC (1993) Nonoperatively treated isolated posterior cruciate ligament injuries. Am J Sports Med 21(1):132–136

    Article  CAS  PubMed  Google Scholar 

  11. Kim YM, Lee CA, Matava MJ (2011) Clinical results of arthroscopic single-bundle transtibial posterior cruciate ligament reconstruction: a systematic review. Am J Sports Med 39(2):425–434

    Article  PubMed  Google Scholar 

  12. Kraus VB, McDaniel G, Worrell TW, Feng S, Vail TP, Varju G, Coleman RE (2009) Association of bone scintigraphic abnormalities with knee malalignment and pain. Ann Rheum Dis 68(11):1673–1679

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Li X, Benjamin Ma C, Link TM, Castillo DD, Blumenkrantz G, Lozano J, Carballido-Gamio J, Ries M, Majumdar S (2007) In vivo T(1rho) and T(2) mapping of articular cartilage in osteoarthritis of the knee using 3 T MRI. Osteoarthr Cartil 15(7):789–797

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Li X, Cheng J, Lin K, Saadat E, Bolbos RI, Jobke B, Ries MD, Horvai A, Link TM, Majumdar S (2011) Quantitative MRI using T1rho and T2 in human osteoarthritic cartilage specimens: correlation with biochemical measurements and histology. Magn Reson Imaging 29(3):324–334

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Lopez-Vidriero E, Simon DA, Johnson DH (2010) Initial evaluation of posterior cruciate ligament injuries: history, physical examination, imaging studies, surgical and nonsurgical indications. Sports Med Arthrosc 18(4):230–237

    Article  PubMed  Google Scholar 

  16. Mariani PP, Adriani E, Santori N, Maresca G (1997) Arthroscopic posterior cruciate ligament reconstruction with bone-tendon-bone patellar graft. Knee Surg Sports Traumatol Arthrosc 5(4):239–244

    Article  CAS  PubMed  Google Scholar 

  17. Patel DV, Allen AA, Warren RF, Wickiewicz TL, Simonian PT (2007) The nonoperative treatment of acute, isolated (partial or complete) posterior cruciate ligament-deficient knees: an intermediate-term follow-up study. HSS J 3(2):137–146

    Article  PubMed  PubMed Central  Google Scholar 

  18. Sekiya JK, West RV, Ong BC, Irrgang JJ, Fu FH, Harner CD (2005) Clinical outcomes after isolated arthroscopic single-bundle posterior cruciate ligament reconstruction. Arthroscopy 21(9):1042–1050

    Article  PubMed  Google Scholar 

  19. Shelbourne KD, Davis TJ, Patel DV (1999) The natural history of acute, isolated, nonoperatively treated posterior cruciate ligament injuries. A prospective study. Am J Sports Med 27(3):276–283

    CAS  PubMed  Google Scholar 

  20. Shelbourne KD, Muthukaruppan Y (2005) Subjective results of nonoperatively treated, acute, isolated posterior cruciate ligament injuries. Arthroscopy 21(4):457–461

    Article  PubMed  Google Scholar 

  21. Takayama Y, Hatakenaka M, Tsushima H, Okazaki K, Yoshiura T, Yonezawa M, Nishikawa K, Iwamoto Y, Honda H (2013) T1ρ is superior to T2 mapping for the evaluation of articular cartilage denaturalization with osteoarthritis: radiological-pathological correlation after total knee arthroplasty. Eur J Radiol 82(4):e192–e198

    Article  PubMed  Google Scholar 

  22. Theologis AA, Haughom B, Liang F, Zhang Y, Majumdar S, Link TM, Ma CB, Li X (2014) Comparison of T1rho relaxation times between ACL-reconstructed knees and contralateral uninjured knees. Knee Surg Sports Traumatol Arthrosc 22:298–307

    Article  PubMed  PubMed Central  Google Scholar 

  23. Tsushima H, Okazaki K, Takayama Y, Hatakenaka M, Honda H, Izawa T, Nakashima Y, Yamada H, Iwamoto Y (2012) Evaluation of cartilage degradation in arthritis using T1rho magnetic resonance imaging mapping. Rheumatol Int 32(9):2867–2875

    Article  CAS  PubMed  Google Scholar 

  24. Wu CH, Chen AC, Yuan LJ, Chang CH, Chan YS, Hsu KY, Wang CJ, Chen WJ (2007) Arthroscopic reconstruction of the posterior cruciate ligament by using a quadriceps tendon autograft: a minimum 5-year follow-up. Arthroscopy 23(4):420–427

    Article  PubMed  Google Scholar 

  25. Young AA, Stanwell P, Williams A, Rohrsheim JA, Parker DA, Giuffre B, Ellis AM (2005) Glycosaminoglycan content of knee cartilage following posterior cruciate ligament rupture demonstrated by delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC). A case report. J Bone Joint Surg Am 87(12):2763–2767

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare that there was no conflict of interest regarding this study.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-0054, Japan

    Ken Okazaki, Kanji Osaki, Hideki Mizu-uchi, Satoshi Hamai & Yukihide Iwamoto

  2. Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    Yukihisa Takayama, Yoshio Matsuo & Hiroshi Honda

Authors
  1. Ken Okazaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yukihisa Takayama
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kanji Osaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yoshio Matsuo
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hideki Mizu-uchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Satoshi Hamai
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hiroshi Honda
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Yukihide Iwamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ken Okazaki.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Okazaki, K., Takayama, Y., Osaki, K. et al. Subclinical cartilage degeneration in young athletes with posterior cruciate ligament injuries detected with T1ρ magnetic resonance imaging mapping. Knee Surg Sports Traumatol Arthrosc 23, 3094–3100 (2015). https://doi.org/10.1007/s00167-014-3469-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-014-3469-4

Keywords

Search

Navigation