If anybody has an opinion, please share. I was told that the MRI results could show an ACL retear when is really masked by scar tissue from the original reconstruction. The damage to the meniscus is obvious, but to what degree?
Here's the Evaluation:
"Evaluation of the reconstructed anterior cruciate ligament as described above. The patella displays a slight degree of lateral static subluxation. The patellar and quadriceps as well as the patellar retinacula are within normal limits. Some decreased T2 and STIR signal is seen along the posterior aspect of Hoffa’s fat pad in a linear fashion likely related to some mild arthrofibrosis. No other abnormalities of Hoffa’s fat pad are seen.
Evaluation of the menisci reveals blunting and truncation in the posterior body, posterior junction zone, and posterior horn of the medial meniscus. Diffuse increased signal is also seen through the free edge of the meniscus in these locations. These findings are likely the sequela of fraying and tearing of the meniscus. Postoperative changes are possible as well if prior medial meniscal repair was performed. Clinical correlation is advised. These areas are seen to mildly enhance with contrast. The body the medial meniscus is diminutive with some horizontal grade III signal seen extending through it likely the sequela of horizontal tearing in this location as well.
Evaluation of the lateral meniscus reveals prominent globular signal in the posterior horn/posterior junction zone of the lateral meniscus without distinct extension to an articular surface on the sagittal imaging with questionable extension to the inferior articular surface on coronal imaging. This likely represents the sequela of severe degeneration and/or contusion. Superimposed meniscal fraying cannot excluded.
1. Complete disruption of the reconstructed anterior cruciate ligament. There is associated mild anterior drawing of the tibia present.
2. Reactive edema around, versus grade I sprain of, the medial collateral ligament.
3. Blunting and truncation of the free edge of the posterior horn, posterior junction zone, and posterior body of the medial meniscus with increased signal through the free edge in these locations as well, findings likely the sequela free edge tearing and fraying. Correlation with the prior surgery that was performed in December 2004 is recommended to ensure that medial repair did not take place as these findings could also be related to granulation tissue from the meniscal repair. There is also horizontal grade III signal in the body the medial meniscus not of fluid intensity suspicious for a horizontal tear in this location as well.
4. Severe myxomatous degeneration of, versus contusion of, the posterior junction zone and posterior horn of the lateral meniscus. Superimposed fraying cannot be excluded with no distinct meniscal tear identified.
5. Large joint effusion with non-thickened medial plica.
6. Baker’s cyst.
7. Mild linear arthrofibrosis along the posterior aspect of Hoffa’s fat pad.