SCIENTIFIC ARTICLE Arthroscopic all-inside meniscal repair—Does the meniscus heal? A clinical and radiological follow-up examination to verify meniscal healing using a 3-T MRI Thomas Hoffelner & Herbert Resch & Rosemarie Forstner & Mayer Michael & Bernd Minnich & Mark Tauber Received: 16 February 2010 / Revised: 18 April 2010 / Accepted: 6 May 2010 # ISS 2010 Abstract Objective The purpose of this study was to correlate clinical and radiological results using a 3-T MRI to verify meniscal healing after arthroscopic all-inside meniscus repair. Materials and methods We selected 27 patients (14 men and 13 women) with an average age of 31±9 years and retrospective clinical examinations and radiological assess- ments using a 3-T MRI after all-inside arthroscopic meniscal repair were conducted. Repair of the medial meniscus was performed in 19 patients and of the lateral meniscus in eight. In 17 patients (63%), we performed concomitant anterior cruciate ligament reconstruction. The mean follow-up period was 4.5±1.7 years. The Lysholm score and Tegner activity index were used for clinical evaluation. Four grades were used to classify the radiolog- ical signal alterations within the meniscus: central globular (grade 1); linear horizontal or band-like (grade 2); intra- meniscal alterations and linear signal alterations communi- cating with the articular surface (grade 3); and complex tears (grade 4). Results At follow-up, the average Lysholm score was 76± 15 points, with ten of the patients placed in group 6 based on the Tegner activity index. MRI examinations revealed no signal alteration in three patients, grade 1 in 0, grade 2 in five, grade 3 in 13, and grade 4 in six. The MRI findings correlated positively with the clinical scores in 21 patients (78%). Conclusions Correlation of clinical and radiological exam- ination was performed using 3-T MRI. In spite of satisfac- tory clinical outcomes at follow-up, a radiological signal alteration may still be visible on MRI, which was believed to be scar tissue, but could not be proven definitively. Imaging with a 3-Tesla MRI after meniscal suture surgery provides good but no definitive reliability on meniscus healing and therefore gives no advantage compared to 1.5-T MRI, with good clinical outcome using an all-inside arthroscopic meniscal repair. Clinical relevance 3T-MRI can not substitute diagnostic arthroscopy in patients with persistent complaints after arthroscopic all-inside meniscal repair. Level of evidence Retrospective case series (EBM Level IV) Keywords 3-T MRI . Arthroscopy . Meniscal suture . All-inside repair technique . FasT-Fix Device Introduction The biomechanical and biological relevance of the menis- cus for the knee joint is well documented. Loss of meniscal tissue induces an adverse process with accelerated devel- opment of degenerative osteochondral lesions [1–6]. How- T. Hoffelner (*) : H. Resch : M. Michael : M. Tauber Department of Traumatology and Sports Injuries, 5020, Muellner Hauptstrasse 48, Salzburg, Austria e-mail: t.hoffelner@salk.at R. Forstner Department of Radiology, University Hospital of Salzburg, Salzburg, Austria B. Minnich Department of Organismic Biology, University of Salzburg, Salzburg, Austria Skeletal Radiol DOI 10.1007/s00256-010-0965-6