Follow-up of posttraumatic ligamentous and meniscal knee lesions detected at MR imaging: Systematic review

Purpose: To perforin a systematic review of the literature regarding the natural course of ligamentous and meniscal knee lesions detected at magnetic resonance (MR) imaging. Materials and Methods: The MEDLINE database was searched from January 1966 to February 2003. Studies were included if all of the following criteria were met: patients had collateral ligament, cruciate ligament, or meniscal lesions: MR imaging was p -forined in all parients; saidy incloded a group and/or subgroup of patients who underwent conservative treatment during follow-up; patients returned to the clinic for rollow-tip and clinical clata or AIR iniaging ontconies were noted: and article was written in English, Dutch, German, French, Spanish, Italian, Swedish. Danish. or Norwegian. The quality of each study was assessed by using a standardized criteria set, and K statistics were used to grade the level of agreement between the two reviewers. Studies with quality scores or 8 or more were designated as high quality. Results were compared with regard to study design and quality scores. Results: The literature search identified 649 articles, and 11 studies (five on posterior cruciate ligament [PCL] injuries. five on anterior cruciate ligament [ACL] injuries. and one oil meniscal injuries) met the inclusion criteria. No studies on the follow-up of collateral ligament injuries were identified. Four studies were of high quality, and the kappa value for quality items was 0.80. Between 77% and 93% of the partial or complete, PCL ruptures regained continuity. In cases of partial or total ACL rupture.. repair of continuity was also possible. A possible association between kill inta-ing continUitNI and clinical stability was identified. Conclusion: The ACL and PCL can regain continuity after partial or complete rupture. On the basis of this review, no conclusions can be drawn about the natural course of meniscal or collateral ligament. injury seen at, MR imaging.