Evaluation of Articular Cartilage Injury Using Computed Tomography With Axial Traction in the Ankle Joint

2018 ◽  
Vol 39 (9) ◽  
pp. 1120-1127 ◽  
Author(s):  
Tomoyuki Nakasa ◽  
Yasunari Ikuta ◽  
Mikiya Sawa ◽  
Masahiro Yoshikawa ◽  
Yusuke Tsuyuguchi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Articular Cartilage ◽  
Sensitivity And Specificity ◽  
Subchondral Bone ◽  
Ct Images ◽  
Cartilage Layer ◽  
Arthroscopic Findings ◽  
Cartilage Injuries ◽  
Axial Traction ◽  
Articular Cartilage Injuries

Background: Although chondral or osteochondral injuries are usually assessed by magnetic resonance imaging, its accuracy can be low, presumably related to the relatively thin cartilage layer and the close apposition of the cartilage of the talus and tibial plafond. We hypothesized that axial traction could provide a contrast between the articular cartilage and joint cavity, and it enabled the simultaneous evaluation of cartilage and subchondral bone. The purpose of this study was to assess the feasibility of using computed tomography (CT) imaging with axial traction for the diagnosis of articular cartilage injuries. Methods: Chondral lesions in 18 ankles were evaluated by CT with axial traction using a tensioning device and ankle strap for enlargement of the joint space of the ankle. CT was done in 3-mm slices and programmed for gray scale, and then CT images were allocated colors to make it easier to evaluate the cartilage layer. The International Cartilage Repair Society (ICRS) grades on CT were compared with those on arthroscopic findings. Results: The respective sensitivity and specificity of CT imaging with traction using ICRS grading were 74.4%, and 96.3%. The level of agreement of the ICRS grading between CT images and arthroscopic findings was moderate (kappa coefficient, 0.547). Adding axial traction to CT increased the delineation of the cartilage surface, including chondral thinning, chondral defect, and cartilage separation. Conclusions: CT with axial traction produced acceptable levels of sensitivity and specificity for the evaluation of articular cartilage injuries, in addition to the assessment of subchondral bone. Level of Evidence: Level III, comparative case series.

scholarly journals Evaluation of articular cartilage injury using computed tomography with axial traction in ankle joint

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0036
Author(s):  
Tomoyuki Nakasa ◽  
Yasunari Ikuta ◽  
Masahiro Yoshikawa ◽  
Yusuke Tsuyuguchi ◽  
Yuki Ota ◽  
...  
Keyword(s):  
Articular Cartilage ◽  
Sensitivity And Specificity ◽  
Subchondral Bone ◽  
Ct Images ◽  
Cartilage Injury ◽  
Cartilage Layer ◽  
Arthroscopic Findings ◽  
Cartilage Injuries ◽  
Axial Traction ◽  
Articular Cartilage Injuries

Category: Ankle Introduction/Purpose: Although chondral or osteochondral injuries are usually assessed by MRI, its accuracy is reportedly low because of the relatively thin cartilage layer and its close apposition to the cartilage talus and tibial plafond. The subchondral bone plays a role in cartilage metabolism, therefore the evaluation of subchondral bone is crucial for cartilage treatment. A method which enables the simultaneous evaluation of cartilage and subchondral bone is useful for the treatment of cartilage injury. The purpose of this study was to assess the feasibility of CT imaging with axial traction for the diagnosis of articular cartilage injuries. Methods: Chondral lesion in 18 ankles of 17 patients were evaluated. These 18 ankles consisted of 11 ankles of osteochondral lesion of the talar dome (OLT), 5 ankles of osteoarthritis of ankle joints and 2 ankles of anterior impingement syndrome. Twelve males and 5 women were included, with a mean age of 33.7 years (range, 15 -70 years). An ankle distractor foot strap was placed on the ankle with 30 degrees flexion of the knee joint, and a traction force of 80 N was applied during CT scanning. Gray scale CT images were allocated colors to make it easier to evaluate the cartilage layer. The international Cartilage Repair Society (ICRS) grades on CT were compared with those in arthroscopic findings. Results: The respective sensitivity and specificity of CT imaging with traction compared to ICRS grading were 74.4%, and 96.3%. The level of agreement of the ICRS grading between CT images and arthroscopic findings showed moderate (kappa coefficient; 0.547). The diagnosis of grade 3 or 4 lesions had 80.0% sensitivity. Axial traction to CT enabled the delineation of the cartilage surface including chondral thinning, defect and cartilage separation more visible (Figure 1). Conclusion: CT with axial traction could obtain acceptable levels of sensitivity and specificity for the evaluation of articular cartilage injuries in addition to the assessment of subchondral bone.

Treatment of Articular Cartilage Injuries in the Knee

2009 ◽  
Author(s):  
Tony Wanich
Keyword(s):  
Extracellular Matrix ◽  
Articular Cartilage ◽  
Thin Layer ◽  
Subchondral Bone ◽  
Articular Surface ◽  
Low Friction ◽  
Cartilage Injuries ◽  
Articular Cartilage Injuries

Articular cartilage is a unique biphasic tissue composed of chondrocytes surrounded by extracellular matrix (ECM). This thin layer of tissue covers the articular surface of diarthroidal joints and provides a durable, low friction interface which also helps to reduce the load transmitted to the underlying subchondral bone.

scholarly journals Use of Particulated Juvenile Articular Cartilage Allograft for Osteochondral Lesions of the Wrist

Hand ◽  
2016 ◽  
Vol 12 (5) ◽  
pp. NP62-NP67 ◽  
Author(s):  
Daniel E. Hess ◽  
Brian C. Werner ◽  
D. Nicole Deal
Keyword(s):  
Articular Cartilage ◽  
Case Reports ◽  
New Technology ◽  
Full Range ◽  
Osteochondral Lesions ◽  
Appropriate Treatment ◽  
Cartilage Injuries ◽  
Articular Cartilage Injuries ◽  
Outerbridge Grade ◽  
Active Patients

Background: Articular cartilage injuries are a common injury among young, active patients, and the most appropriate treatment for these injuries remains controversial. A promising new technology in the treatment of high-grade cartilage injuries is particulated juvenile articular cartilage (PJAC) allograft (DeNovo NT, Zimmer, Warsaw, Indiana). This has been shown to be successful in multiple joints including the knee, talus, and elbow. No studies or case reports exist in supporting or discouraging its use in injuries of the wrist, in specific, the scaphoid. Methods: The use of PJAC allograft is described for the treatment of an active 21-year-old male with an Outerbridge Grade IV chondral lesion on the proximal pole of his right scaphoid and right distal radius scaphoid facet who had failed conservative management. The patient was followed clinically and radiographically for 21 months. Results: The patient had return to full sport (jujutsu) and full range-of-motion, both of which represented an improvement from his preoperative exam. Radiographically, the chondral lucency seen had decreased in size and was almost completely absent on radiographs after 21 months. Conclusions: The results of this case suggest that PJAC can be used safely and effectively in the wrist thereby potentially broadening the indications for its use.

MR imaging of post-traumatic articular cartilage injuries confined to the femoral trochlea

2005 ◽  
Vol 53 (1) ◽  
pp. 90-95 ◽  
Author(s):  
Rolf W. Huegli ◽  
Sonja M.C. Moelleken ◽  
Alexander Stork ◽  
Harald M. Bonel ◽  
Miriam A. Bredella ◽  
...  
Keyword(s):  
Articular Cartilage ◽  
Mr Imaging ◽  
Femoral Trochlea ◽  
Cartilage Injuries ◽  
Post Traumatic ◽  
Articular Cartilage Injuries

Arthroscopic Diagnosis and Treatment of Knee Articular Cartilage Injuries in Children

2003 ◽  
Vol 10 (2) ◽  
pp. 74-78
Author(s):  
V N Merkulov ◽  
E A Karam ◽  
O G Sokolov ◽  
A G El'tsin ◽  
V N Merkulov ◽  
...  
Keyword(s):  
Articular Cartilage ◽  
Children And Adolescents ◽  
Knee Arthroscopy ◽  
Knee Injuries ◽  
Knee Function ◽  
Cartilage Injuries ◽  
Knee Trauma ◽  
Articular Cartilage Injuries ◽  
Acute Knee

Experience in knee arthroscopy in children with acute knee trauma and sequelae of knee injuries is presented. There were 417 patients, aged 4-18, who were under treatment at the clinic in the period from 1994 to 2002. One hundred forty four patients (34.5%) had injury of articular cartilage. In 12 cases diagnostic and in 132 cases diagnostic and curative arthroscopy was performed. Evident advantages of arthroscopy in diagnosis of intraarticular knee structures injuries, especially cartilagenous tissue were emphasized. Protocol of diagnostic examination including clinical, roentgenologic, ultrasonographic methods as well as CT and MRT (as indicated) is suggested. Indications to knee arthroscopy in children and adolescents are determined. Clinical-arthroscopic classification of knee articular cartilage injuries is given. Due to exact diagnosis and adequate curative tactics total restoration of knee function was achieved in 75% of patients with articular cartilage injuries.

Sign in / Sign up

Export Citation Format

Share Document