Diagnosis and follow-up MRI evaluation of tennis leg:New understanding of the pathogenesis and imaging

Injury ◽  
2021 ◽  
Author(s):  
Meng Dai ◽  
Xi Liu ◽  
Xiaoming Liu ◽  
Lian Yang ◽  
Deyu Duan
Keyword(s):  
Mri Evaluation

Matrix-Applied Characterized Autologous Cultured Chondrocytes Versus Microfracture: Five-Year Follow-up of a Prospective Randomized Trial

2018 ◽  
Vol 46 (6) ◽  
pp. 1343-1351 ◽  
Author(s):  
Mats Brittberg ◽  
David Recker ◽  
John Ilgenfritz ◽  
Daniel B.F. Saris ◽  
Keyword(s):  
Clinical Trial ◽  
Informed Consent ◽  
Extension Study ◽  
Cartilage Defects ◽  
Efficacy And Safety ◽  
Randomized Controlled ◽  
And Function ◽  
Mri Evaluation ◽  
Cultured Chondrocytes

Background: Matrix-based cell therapy improves surgical handling, increases patient comfort, and allows for expanded indications with better reliability within the knee joint. Five-year efficacy and safety of autologous cultured chondrocytes on porcine collagen membrane (MACI) versus microfracture for treating cartilage defects have not yet been reported from any randomized controlled clinical trial. Purpose: To examine the clinical efficacy and safety results at 5 years after treatment with MACI and compare these with the efficacy and safety of microfracture treatment for symptomatic cartilage defects of the knee. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: This article describes the 5-year follow-up of the SUMMIT (Superiority of MACI Implant Versus Microfracture Treatment) clinical trial conducted at 14 study sites in Europe. All 144 patients who participated in SUMMIT were eligible to enroll; analyses of the 5-year data were performed with data from patients who signed informed consent and continued in the Extension study. Results: Of the 144 patients randomized in the SUMMIT trial, 128 signed informed consent and continued observation in the Extension study: 65 MACI (90.3%) and 63 microfracture (87.5%). The improvements in Knee injury and Osteoarthritis Outcome Score (KOOS) Pain and Function domains previously described were maintained over the 5-year follow-up. Five years after treatment, the improvement in MACI over microfracture in the co-primary endpoint of KOOS pain and function was maintained and was clinically and statistically significant ( P = .022). Improvements in activities of daily living remained statistically significantly better ( P = .007) in MACI patients, with quality of life and other symptoms remaining numerically higher in MACI patients but losing statistical significance relative to the results of the SUMMIT 2-year analysis. Magnetic resonance imaging (MRI) evaluation of structural repair was performed in 120 patients at year 5. As in the 2-year SUMMIT (MACI00206) results, the MRI evaluation showed improvement in defect filling for both treatments; however, no statistically significant differences were noted between treatment groups. Conclusion: Symptomatic cartilage knee defects 3 cm2 or larger treated with MACI were clinically and statistically significantly improved at 5 years compared with microfracture treatment. No remarkable adverse events or safety issues were noted in this heterogeneous patient population.

One-Step Treatment for Patellar Cartilage Defects With a Cell-Free Osteochondral Scaffold: A Prospective Clinical and MRI Evaluation

2017 ◽  
Vol 45 (7) ◽  
pp. 1581-1588 ◽  
Author(s):  
Francesco Perdisa ◽  
Giuseppe Filardo ◽  
Andrea Sessa ◽  
Maurizio Busacca ◽  
Stefano Zaffagnini ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Clinical Outcome ◽  
Cartilage Defects ◽  
Osteochondral Lesions ◽  
Repair Tissue ◽  
Osteochondral Scaffold ◽  
Patellar Cartilage ◽  
A Cell ◽  
Mri Evaluation

Background: The treatment of symptomatic cartilage defects of the patella is particularly challenging, and no gold standard is currently available. Purpose: To evaluate the clinical results of a biphasic cell-free collagen-hydroxyapatite scaffold and to evaluate osteochondral tissue regeneration with magnetic resonance imaging (MRI). Study Design: Case series; Level of evidence, 4. Methods: Thirty-four patients (18 men and 16 women; mean ± SD: age, 30.0 ± 10 years) were treated by scaffold implantation for knee chondral or osteochondral lesions of the patella (area, 2.1 ± 1 cm2). The clinical evaluation was performed prospectively at 12 and 24 months via the IKDC (International Knee Documentation Committee; objective and subjective) and Tegner scores. MRI evaluation was performed at both follow-ups in 18 lesions through the MOCART score (magnetic resonance observation of cartilage repair tissue) and specific subchondral bone parameters. Results: A statistically significant improvement in all the scores was observed at 12- and 24-month follow-up as compared with the basal evaluation. The IKDC subjective score improved from 39.5 ± 14.5 to 61.9 ± 14.5 at 12 months ( P > .0005) with a further increase to 67.6 ± 17.4 at 24 months of follow-up (12-24 months, P = .020). The MRI evaluation showed a stable value of the MOCART score between 12 and 24 months, with a complete filling of the cartilage in 87.0% of the lesions, complete integration of the graft in 95.7%, and intact repair tissue surface in 69.6% at final follow-up. The presence of osteophytes or more extensive bony overgrowth was documented in 47.8% of the patients of this series, but no correlation was found between MRI findings and clinical outcome. Conclusion: The implantation of a cell-free collagen-hydroxyapatite osteochondral scaffold provided a clinical improvement at short-term follow-up for the treatment of patellar cartilage defects. Women had lower outcomes, and the need for realignment procedures led to a slower recovery. MRI evaluation showed some abnormal findings with the presence of bone overgrowth, but no correlation has been found with the clinical outcome.

scholarly journals Hip MRI findings and outcomes following imaging-guided hip injections

2020 ◽  
Vol 93 (1108) ◽  
pp. 20190817
Author(s):  
Laura Pochon ◽  
Cynthia K. Peterson ◽  
Reto Sutter ◽  
Filippo Del Grande ◽  
Erika J. Ulbrich ◽  
...  
Keyword(s):  
Cartilage Defects ◽  
Outcome Study ◽  
Mri Findings ◽  
Significant Treatment ◽  
Change Scores ◽  
Time Points ◽  
Global Impression Of Change ◽  
Mri Evaluation ◽  
Hip Injection

Objective: To determine if MRI findings prior to intra-articular corticosteroid hip infiltration are related to treatment outcomes. Methods: This prospective outcome study with retrospective MRI evaluation includes 100 consecutive patients with MRI within 6 months before a therapeutic intra-articular hip injection. Labrum, bone marrow, acetabular and femoral cartilage abnormalities were assessed by two radiologists blinded to patient outcomes: the proportion reporting "improvement" on the Patient’s Global Impression of Change (PGIC) scale at 1 day, 1 week and 1 month follow-up were compared based on MRI findings using χ2. The t-test was used to compare pain change scores with MRI abnormalities. Results: Patients with a normal labrum in the posterosuperior quadrant were more likely to report PGIC "improvement" at 1 week compared to labral degeneration (p = 0.048). Significant differences in pain change scores were found at all time points for the labral anteroinferior quadrant (p = 0.001, 1 day; p = 0.010, 1 week; p = 0.034, 1 month) with the highest reduction in patients with labral degeneration. Females were 2.80 times more likely to report clinically relevant "improvement" at 1 day (p = .049) and 2.90 times more likely to report clinically relevant "improvement" at 1 month (p = .045). Conclusion: Cartilage defects and marrow abnormalities were not associated with outcomes. Patients with a normal labrum in the posterosuperior quadrant had better outcomes at 1 week. Patients with labral degeneration of the anteroinferior quadrant had higher levels of pain reduction at all time points. Females were significantly more likely to report PGIC "improvement" Advances in knowledge: A significant treatment outcome was observed amongst gender, although there were no significant differences in the MRI findings.

Magnetic Resonance Imaging After Arthroscopic Microfracture of Capitellar Osteochondritis Dissecans

2012 ◽  
Vol 40 (11) ◽  
pp. 2549-2556 ◽  
Author(s):  
Corey A. Wulf ◽  
Rebecca M. Stone ◽  
M. Russell Giveans ◽  
Gregory N. Lervick
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Osteochondritis Dissecans ◽  
Articular Surface ◽  
Resonance Imaging ◽  
Arthroscopic Microfracture ◽  
The Mean ◽  
Magnetic Resonance Imaging Mri ◽  
Mri Evaluation

Background: Osteochondritis dissecans (OCD) of the capitellum affects young athletes involved in elbow load-bearing activities. Unstable lesions are best managed surgically, although debate remains regarding the optimal method. Arthroscopic treatment allows rapid recovery, but the effect on the articular surface is undetermined. Hypothesis: The clinical outcome after arthroscopic microfracture of stage III/IV capitellum OCD would be successful in terms of return to sport and restoration of function, and there would be some evidence of articular restoration or repair. Study Design: Case series; Level of evidence, 4. Methods: We reviewed records of 10 consecutive adolescent patients (age ≤18 years) with stage III or IV OCD lesions of the capitellum managed with arthroscopic microfracture. The mean age at the time of surgery was 13.9 years (range, 10.8-18.5 years); 7 patients were skeletally immature and 3 were skeletally mature. Pre- and postoperative functional assessment included active range of motion, Mayo Elbow Performance Score (MEPS), and Timmerman/Andrews elbow score. All patients underwent plain radiographic and magnetic resonance imaging (MRI) evaluation at a minimum of 12 months (mean, 27 months; range, 12-49 months) and clinical evaluation at a minimum of 24 months (mean, 42 months; range, 27-54 months) after surgery. Results: The mean range of motion improved in both flexion (135.8°→140.7°, P = .112) and extension (20.4°→–2.2°, P = .005). The mean MEPS (70.5→97, P = .007) and Timmerman/Andrews elbow scores (116.4→193.0, P = .008) improved significantly. magnetic resonance imaging (MRI) evaluation demonstrated an improvement in overall joint congruence and the formation of a reparative articular surface in 8 of 10 (80%) patients. No reoperations or major complications were encountered. Six of 8 patients involved in competitive athletics returned to the same level of participation at an average of 5.1 months. Conclusion: Arthroscopic OCD fragment excision and capitellar microfracture demonstrates good to excellent functional results in short-term follow-up. Follow-up MRI suggests potential for a reparative fibrocartilaginous articular surface. Longer term follow-up is necessary to determine durability of the technique.

scholarly journals Clinical and MRI Evaluation of Meniscal Tears Repaired with Bioabsorbable Arrows

2007 ◽  
Vol 96 (3) ◽  
pp. 252-255 ◽  
Author(s):  
L. Tielinen ◽  
J. Lindahl ◽  
S. Koskinen ◽  
E. Hirvensalo
Keyword(s):  
Ligament Reconstruction ◽  
Healing Rate ◽  
Good Alternative ◽  
Meniscus Repair ◽  
University Hospital ◽  
Meniscal Tears ◽  
Secondary Surgery ◽  
Meniscal Tissue ◽  
Mri Evaluation

Background and Aims: Excision of meniscal tissue has been shown to increase the risk of degenerative changes of the knee joint. Whenever possible, meniscus repair has become the procedure of choice for treatment of meniscal tears. Materials and Methods: The present retrospective study evaluated the healing results of 77 meniscal ruptures treated with the an all-inside technique (Biofix meniscus arrow). The study group consisted of 73 patients with 77 longitudinal, vertical meniscal ruptures treated at Helsinki University Hospital between the beginning of January 1997 and the end of March 2001. The patients who had not received secondary surgery for failed repair during the follow-up period were examined clinically and with MRI. Results: Fifty-one out of 77 meniscal ruptures (66%) healed clinically. In repairs performed in conjunction with ligament reconstruction the healing rate was higher (79%) than in the isolated tears (56%). The poorest results were seen in the very long vertical tears with luxation of the meniscus (38% healing rate). Conclusions: Bioabsorbable arrows offer a good alternative for treatment of meniscal ruptures, but the arrows alone do not seem to be sufficient to provide a reliable long-lasting result in the repair of very unstable meniscal ruptures.

scholarly journals MRI Evaluation of Isolated Arthroscopic Partial Meniscectomy Patients at a Minimum Five-Year Follow-up

2006 ◽  
Vol 3 (1) ◽  
pp. 35-43 ◽  
Author(s):  
Riley J. Williams ◽  
Kristin K. Warner ◽  
Frank A. Petrigliano ◽  
Hollis G. Potter ◽  
Joshua Hatch ◽  
...  
Keyword(s):  
Partial Meniscectomy ◽  
Arthroscopic Partial Meniscectomy ◽  
Mri Evaluation

scholarly journals Outcome following cervicothoracic junction fusion in T1 pathological fracture of breast cancer spinal metastases: a case report

2020 ◽  
Vol 8 (9) ◽  
pp. 3389
Author(s):  
Ni Made Puspa Dewi Astawa ◽  
I. Gusti Lanang Ngurah Agung Artha Wigun ◽  
Ivander Purvance ◽  
Gusti Ngurah Putra Stanu ◽  
Herryanto Agustriadi Simanjuntak ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Spinal Metastases ◽  
Left Breast ◽  
Cervicothoracic Junction ◽  
Fusion Procedure ◽  
Motor Disturbance ◽  
Pain Status ◽  
History Of ◽  
Mri Evaluation

The cervicothoracic junction (CTJ) is defined as the area extending from vertebral segment C7 to T2. Spinal metastases of CTJ are rare, range from 10% to less than 20%. A 47-year-old woman complained sensory and motor disturbance since 3 weeks prior to admission. History of lump on the left breast was confirmed. Neurological deficit was confirmed as ASIA C at the time of diagnosis. MRI finding suggest fracture of T1 vertebral body with kypothic angle 28° that causing anterior compression of spinal cord. The patient underwent decompression and posterior fusion from C4 to T4. A biopsy sample was also collected from the spine and left breast to confirm the diagnosis. Patient evaluation was done during discharge and at certain points of follow-up for improvement on its neurological, pain, and functional status. An MRI evaluation was performed to evaluate spinal stability and fusion. Significant improvements were observed in patient ambulatory and pain status. Cervicothoracic junction fusion procedure is a considerable choice for the management of pathological vertebral fractures with cervicothoracic junction involvement caused by spinal metastases of breast cancer.

scholarly journals Non-operatively managed small to medium-sized subscapularis tendon tears: MRI evaluation with a minimum of 5 years follow-up

2021 ◽  
Author(s):  
Anita Hasler ◽  
Andrew Ker ◽  
Tina Passon ◽  
Timo Tondelli ◽  
Christian Gerber ◽  
...  
Keyword(s):  
Subscapularis Tendon ◽  
Tendon Tears ◽  
Mri Evaluation
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