Magnetic Resonance Imaging to Assess Knee Cartilage Repair Tissue After Microfracture of Chondral Defects

2010 ◽  
Vol 20 (03) ◽  
pp. 228-234 ◽  
Author(s):  
Arun Ramappa ◽  
Thomas Gill ◽  
Catharine Bradford ◽  
Charles Ho ◽  
J. Steadman
Cartilage ◽  
2017 ◽  
Vol 9 (3) ◽  
pp. 223-236 ◽  
Author(s):  
Daichi Hayashi ◽  
Xinning Li ◽  
Akira M. Murakami ◽  
Frank W. Roemer ◽  
Siegfried Trattnig ◽  
...  

The aims of this review article are (a) to describe the principles of morphologic and compositional magnetic resonance imaging (MRI) techniques relevant for the imaging of knee cartilage repair surgery and their application to longitudinal studies and (b) to illustrate the clinical relevance of pre- and postsurgical MRI with correlation to intraoperative images. First, MRI sequences that can be applied for imaging of cartilage repair tissue in the knee are described, focusing on comparison of 2D and 3D fast spin echo and gradient recalled echo sequences. Imaging features of cartilage repair tissue are then discussed, including conventional (morphologic) MRI and compositional MRI techniques. More specifically, imaging techniques for specific cartilage repair surgery techniques as described above, as well as MRI-based semiquantitative scoring systems for the knee cartilage repair tissue—MR Observation of Cartilage Repair Tissue and Cartilage Repair OA Knee Score—are explained. Then, currently available surgical techniques are reviewed, including marrow stimulation, osteochondral autograft, osteochondral allograft, particulate cartilage allograft, autologous chondrocyte implantation, and others. Finally, ongoing research efforts and future direction of cartilage repair tissue imaging are discussed.


1998 ◽  
Vol 9 (6) ◽  
pp. 377???392 ◽  
Author(s):  
Garry E. Gold ◽  
A. Gahrielle Bergman ◽  
John M. Pauly ◽  
Philipp Lang ◽  
R. Kim Butts ◽  
...  

2013 ◽  
Vol 41 (11) ◽  
pp. NP48-NP50 ◽  
Author(s):  
Tommy S. de Windt ◽  
Goetz H. Welsch ◽  
Mats Brittberg ◽  
Lucienne Vonk ◽  
Stefan Marlovits ◽  
...  

Cartilage ◽  
2020 ◽  
pp. 194760352092670
Author(s):  
Markus M. Schreiner ◽  
Marcus Raudner ◽  
Pavol Szomolanyi ◽  
Kitty Ohel ◽  
Livnat Ben-Zur ◽  
...  

Objective To prospectively assess the efficacy of GelrinC in the treatment of chondral and osteochondral femoral cartilage lesions using morphological (Magnetic Resonance Observation of Cartilage Repair Tissue [MOCART]) and quantitative (T2-mapping) magnetic resonance imaging (MRI). Design This study was designed as a prospective single-arm, open label, multicenter study. Morphological magnetic resonance imaging (MRI) for MOCART assessment and T2 mapping was performed 1 week and 6, 12, 18, and 24 months after GelrinC implantation. Evaluation of T2 mapping was based on the assessment of global T2 indices (T2 of the repair tissue [RT] divided by T2 of healthy reference cartilage) and zonal variation. Results Fifty-six (20 female) patients were prospectively enrolled. The mean MOCART score significantly increased from baseline to the 24-month follow-up with 88.8 (95% CI, 85.8-91.9; P < 0.001) for all lesions combined as well as 86.8 (95% CI, 83.0-90.6) for chondral lesions and 94.1 (95% CI, 68.55-100) for osteochondral lesions. Furthermore, based on T2 mapping, significant zonal variation of the RT was observed at 24 months ( P = 0.039), which did not differ significantly from healthy reference cartilage ( P = 0.6). Conclusion Increasing MOCART scores were observed throughout the follow-up period, indicative of maturation of the cartilage repair. Significant zonal variation of the RT at 24 months might indicate the transformation into hyaline cartilage–like RT. Slightly differing morphological outcome between chondral and osteochondral lesions, but similar global and zonal T2 indices at 24 months, support the potential of GelrinC as a treatment option for both lesion types.


2018 ◽  
Vol 6 (8) ◽  
pp. 232596711878828 ◽  
Author(s):  
Helen S. McCarthy ◽  
Iain W. McCall ◽  
John M. Williams ◽  
Claire Mennan ◽  
Marit N. Dugard ◽  
...  

Background: The ability to predict the long-term success of surgical treatment in orthopaedics is invaluable, particularly in clinical trials. The quality of repair tissue formed 1 year after autologous chondrocyte implantation (ACI) in the knee was analyzed and compared with clinical outcomes over time. Hypothesis: Better quality repair tissue and a better appearance on magnetic resonance imaging (MRI) 1 year after ACI lead to improved longer-term clinical outcomes. Study Design: Cohort study; Level of evidence, 3. Methods: Repair tissue quality was assessed using either MRI (11.5 ± 1.4 [n = 91] or 39.2 ± 18.5 [n = 76] months after ACI) or histology (16.3 ± 11.0 months [n = 102] after ACI). MRI scans were scored using the whole-organ magnetic resonance imaging score (WORMS) and the magnetic resonance observation of cartilage repair tissue (MOCART) score, with additional assessments of subchondral bone marrow and cysts. Histology of repair tissue was performed using the Oswestry cartilage score (OsScore) and the International Cartilage Repair Society (ICRS) II score. Clinical outcomes were assessed using the modified Lysholm score preoperatively, at the time of MRI or biopsy, and at a mean 8.4 ± 3.7 years (maximum, 17.8 years) after ACI. Results: At 12 months, the total MOCART score and some of its individual parameters correlated significantly with clinical outcomes. The degree of defect fill, overall signal intensity, and surface of repair tissue at 12 months also significantly correlated with longer-term outcomes. The presence of cysts or effusion (WORMS) significantly correlated with clinical outcomes at 12 months, while the presence of synovial cysts/bursae preoperatively or the absence of loose bodies at 12 months correlated significantly with long-term clinical outcomes. Thirty percent of repair tissue biopsies contained hyaline cartilage, 65% contained fibrocartilage, and 5% contained fibrous tissue. Despite no correlation between the histological scores and clinical outcomes at the time of biopsy, a lack of hyaline cartilage or poor basal integration was associated with increased pain; adhesions visible on MRI also correlated with significantly better histological scores. Conclusion: These results demonstrate that MRI at 12 months can predict longer-term clinical outcomes after ACI. Further investigation regarding the presence of cysts, effusion, and adhesions and their relationship with histological and clinical outcomes may yield new insights into the mechanisms of cartilage repair and potential sources of pain.


2011 ◽  
Vol 39 (1) ◽  
pp. 161-166 ◽  
Author(s):  
IDA K. HAUGEN ◽  
SEBASTIAN COTOFANA ◽  
MARTIN ENGLUND ◽  
TORE K. KVIEN ◽  
DONATUS DREHER ◽  
...  

Objective.To evaluate whether features of radiographic hand osteoarthritis (OA) are associated with quantitative magnetic resonance imaging (MRI)-defined knee cartilage thickness, radiographic knee OA, and 1-year structural progression.Methods.A total of 765 participants in Osteoarthritis Initiative (OAI; 455 women, mean age 62.5 yrs, SD 9.4) obtained hand radiographs (at baseline), knee radiographs (baseline and Year 1), and knee MRI (baseline and Year 1). Hand radiographs were scored for presence of osteophytes and joint space narrowing (JSN). Knee radiographs were scored according to the Kellgren-Lawrence (KL) scale. Cartilage thickness in the medial and lateral femorotibial compartments was measured quantitatively from coronal FLASHwe images. We examined the cross-sectional and longitudinal associations between features of hand OA (total osteophyte and JSN scores) and knee cartilage thickness, 1-year knee cartilage thinning (above smallest detectable change), presence of knee OA (KL grade ≥ 3), and progression of knee OA (KL change ≥ 1) by linear and logistic regression. Both hand OA features were included in a multivariate model (if p ≤ 0.25) adjusted for age, sex, and body mass index (BMI).Results.Hand JSN was associated with reduced knee cartilage thickness (ß = −0.02, 95% CI −0.03, −0.01) in the medial femorotibial compartment, while hand osteophytes were associated with the presence of radiographic knee OA (OR 1.10, 95% CI 1.03–1.18; multivariate models) with both hand OA features as independent variables adjusted for age, sex, and BMI). Radiographic features of hand OA were not associated with 1-year cartilage thinning or radiographic knee OA progression.Conclusion.Our results support a systemic OA susceptibility and possibly different mechanisms for osteophyte formation and cartilage thinning.


2004 ◽  
Vol 20 (5) ◽  
pp. 850-856 ◽  
Author(s):  
Peter R. Kornaat ◽  
Joost Doornbos ◽  
Aart J. van der Molen ◽  
Margreet Kloppenburg ◽  
Rob G. Nelissen ◽  
...  

2020 ◽  
Vol 29 ◽  
pp. 096368972094358
Author(s):  
Dong Jin Ryu ◽  
Yoon Sang Jeon ◽  
Jun Sung Park ◽  
Gi Cheol Bae ◽  
Jeong-seok Kim ◽  
...  

Biological repair of cartilage lesions remains a significant clinical challenge. A wide variety of methods involving mesenchymal stem cells (MSCs) have been introduced. Because of the limitation of the results, most of the treatment methods have not yet been approved by the Food and Drug Administration (FDA). However, bone marrow aspirate concentrate (BMAC) and human umbilical cord blood derived mesenchymal stem cells (hUCB-MSCs) implantation were approved by Korea FDA. The aim of this study was to evaluate clinical and magnetic resonance imaging (MRI) outcomes after two different types of MSCs implantation in knee osteoarthritis. Fifty-two patients (52 knees) who underwent cartilage repair surgery using the BMAC (25 knees) and hUCB-MSCs (27 knees) were retrospectively evaluated for 2 years after surgery. Clinical outcomes were evaluated according to the score of visual analogue scale (VAS), the International Knee Documentation Committee (IKDC) subjective, and the Knee Injury and Osteoarthritis Outcome Score (KOOS). Cartilage repair was assessed according to the modified Magnetic Resonance Observation of Cartilage Repair Tissue (M-MOCART) score and the International Cartilage Repair Society (ICRS) cartilage repair scoring system. At 2-year follow-up, clinical outcomes including VAS, IKDC, and KOOS significantly improved ( P < 0.05) in both groups; however, there were no differences between two groups. There was no significant difference in M-MOCART [1-year ( P = 0.261), 2-year ( P = 0.351)] and ICRS repair score ( P = 0.655) between two groups. Both groups showed satisfactory clinical and MRI outcomes. Implantation of MSCs from BMAC or hUCB-MSCs is safe and effective for repairing cartilage lesion. However, large cases and a well-controlled prospective design with long-term follow-up studies are needed.


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