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

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.