scholarly journals Bone Marrow Concentrate Does Not Improve Osseous Integration of Osteochondral Allograft Transplants in the Knee: A Comparative Magnetic Resonance Imaging Analysis

2018 ◽  
Vol 6 (7_suppl4) ◽  
pp. 2325967118S0009
Author(s):  
Dean Wang ◽  
Kenneth Lin ◽  
Mollyann D. Pais ◽  
Alissa Burge ◽  
Riley J. Williams
Keyword(s):  
Magnetic Resonance Imaging ◽  
Bone Marrow ◽  
Magnetic Resonance ◽  
Bone Marrow Aspirate ◽  
Osteochondral Allograft ◽  
Full Thickness ◽  
Resonance Imaging ◽  
Control Groups ◽  
Osseous Integration ◽  
And Control

Objectives: Fresh osteochondral allograft transplantation (OCA), which transfers viable, mature hyaline cartilage and subchondral bone into full-thickness chondral defects, has demonstrated good long-term results in the knee. However, incomplete osseous trabecular integration of allograft bone with the host bone is correlated with inferior patient-reported outcomes (Williams et al, JBJS, 2007) and can lead to graft failure. As a result, augmentation of OCA with bone marrow aspirate concentrate (BMAC) has been hypothesized to improve osseous incorporation of the allograft compared to OCA alone. The purpose of this study was to compare the appearance of osseous integration at the host-graft junction on magnetic resonance imaging (MRI) in patients treated with BMAC+OCA versus patients treated with OCA alone. Methods: Between February 2013 and June 2016, 29 patients with full-thickness cartilage defects were treated with BMAC+OCA (n = 10) or OCA alone (n = 19) and followed prospectively with an MRI at approximately 12 months after surgery. Intraoperatively, bone marrow aspirate was harvested from the ipsilateral iliac crest (Magellan, Arteriocyte), and the allograft plug was soaked in BMAC prior to implantation. No patients received a concomitant meniscus allograft transplantation, realignment osteotomy, or anterior ligament reconstruction. Bone, cartilage, and ancillary features on postoperative MRI were assessed and graded using the Osteochondral Allograft MRI Scoring System (OCAMRISS) by a blinded musculoskeletal radiologist. This is a system that scores subchondral bone plate congruity, bone marrow signal intensity, osseous integration, and cystic changes of the graft and host-graft junction as part of the bone features assessment (Meric et al, Cartilage, 2015) (Table 1). Comparisons of demographic characteristics and OCAMRISS scores between groups were performed with the Mann-Whitney test. Results: The mean ages of the BMAC and control groups were 32.9 and 33.4 years, respectively (p = 0.95). Males comprised 60% of the BMAC group and 68% of the control group (p = 0.70). MRIs for the BMAC and control groups were obtained at a mean of 11.2 (range, 9-14) and 11.3 (range, 8-15) months after surgery, respectively (p = 0.87). Mean total OCAMRISS scores were not significantly different between groups (BMAC - 7.8, control - 8.0; p = 0.93). Furthermore, mean bone (BMAC - 2.3, control - 2.8; p = 0.22), cartilage (BMAC - 3.3, control - 3.0; p = 0.55), and ancillary (BMAC - 2.2, control - 2.3; p = 0.92) feature scores were not significantly different between groups. Imaging for 5 patients (50%) in the BMAC and 11 patients (59%) in the control groups (p = 0.71) demonstrated a persistent discernible cleft without crossing trabeculae at the host-graft junction (Figure 1). Almost all grafts (over 90%) demonstrated persistent subchondral marrow edema relative to the epiphyseal bone. Conclusion: The addition of autogenous BMAC to OCA did not enhance osseous integration and bony features at the host-graft junction compared to OCA alone at 12 months. Although more MRI follow-up of patients treated with BMAC+OCA is needed to confirm this finding, these results suggest that any augmentative biologic effect of BMAC for OCA, if one exists, is likely to be small. [Table: see text][Figure: see text]

scholarly journals Comparison of Bone Marrow Aspirate Concentrate and Allogenic Human Umbilical Cord Blood Derived Mesenchymal Stem Cell Implantation on Chondral Defect of Knee: Assessment of Clinical and Magnetic Resonance Imaging Outcomes at 2-Year Follow-Up

2020 ◽  
Vol 29 ◽  
pp. 096368972094358
Author(s):  
Dong Jin Ryu ◽  
Yoon Sang Jeon ◽  
Jun Sung Park ◽  
Gi Cheol Bae ◽  
Jeong-seok Kim ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Stem Cells ◽  
Bone Marrow ◽  
Magnetic Resonance ◽  
Cartilage Repair ◽  
Bone Marrow Aspirate ◽  
Human Umbilical Cord Blood ◽  
Human Umbilical Cord ◽  
Resonance Imaging

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.

Magnetic Resonance Imaging-Based Neuromorphometry in Single Patients –

2012 ◽  
Vol 23 (2) ◽  
pp. 81-96 ◽  
Author(s):  
Jürgen Hänggi
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Cortical Thickness ◽  
Orbitofrontal Cortex ◽  
Social Behaviour ◽  
Brain Regions ◽  
Resonance Imaging ◽  
Control Groups ◽  
And Control ◽  
Lobe Atrophy

The usefulness of MRI-based neuromorphometry for the investigation of single patients is described. A longitudinal cortical thickness analysis in a patient revealed lateral temporal lobe atrophy, suggesting rather semantic than frontotemporal dementia. A boy with the diagnosis of ADHD and control boys were compared and showed cortical thickness increases in the patient in the orbitofrontal cortex contradicting ADHD and suggesting disturbed social behaviour. The multiple synaesthetes E. S. was compared with control groups and showed hyperconnectivity between auditory and gustatory brain regions suggesting that interval-taste synaesthesia is rooted in anatomical alterations. McLeod syndrome patients were investigated and revealed severe atrophy of the caudate nucleus bilateral across time. Additionally, statistical recommendations for the comparison of MRI data of single patients are provided.

scholarly journals Exploring the Effects of Exercise on Brown Adipose Tissue Volumes and T2 Values Using Magnetic Resonance Imaging at 7 Tesla

2021 ◽  
Author(s):  
Yan Zeng ◽  
Lei Gao ◽  
Shuying Shao ◽  
Xiaoshuai Chen ◽  
Ping Zhang ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Adipose Tissue ◽  
Magnetic Resonance ◽  
Brown Adipose Tissue ◽  
7 Tesla ◽  
Control Group ◽  
Resonance Imaging ◽  
Control Groups ◽  
Brown Adipose ◽  
And Control

Abstract Rationale and Objectives: We aimed to evaluate the effect of exercise on brown adipose tissue (BAT) volumes and T2 values in mice. Materials and Methods Twenty-five female Kunming mice were divided into two groups, a running group (n = 5) and a control group (n = 20). After 4 months, all magnetic resonance imaging (MRI) scans of mice were performed on a 7 Tesla (7T) MR scanner with T2-weighted imaging (T2WI) and a T2 mapping sequence. Interscapular brown adipose tissue (BAT) volumes and T2 values were measured. To reduce the impact of weight on the results, we compared the ratio of BAT volumes to body weights (V/W). The data are expressed as mean ± SD, the BAT V/W and T2 values were compared between the control and running groups using the Wilcoxon rank-sum test, P < 0.05 were considered statistically significant. Results Interscapular BAT volumes of the running group (n = 5) and control group (n = 20) were (180.09ml ± 59.80 ml) and (99.98ml ± 35.05ml), respectively. The V/W ratios of the running and control groups were (3.83ml/g ± 0.78ml/g) and (2.17ml/g ± 0.56ml/g), respectively. Interscapular BAT T2 values of the running and control groups were (76.07ms ± 10.82ms) and (61.22ms ± 15.98ms), respectively. Significant differences were found in the BAT V/W ratios (P = 0.0003, P < 0.001) and T2 values between the two groups (P = 0.0096, P < 0.05). BAT volume correlated positively with BAT T2 value (r = 0.75, p = 0.00002). Conclusions MRI is a non-invasive and quantitative method for identifying BAT, especially at ultra-high field like 7T. Long-term running increases BAT volume and T2 value, what's more, BAT volume correlates positively with BAT T2 value.

Bone Marrow Aspirate Concentrate Does Not Improve Osseous Integration of Osteochondral Allografts for the Treatment of Chondral Defects in the Knee at 6 and 12 Months: A Comparative Magnetic Resonance Imaging Analysis

2018 ◽  
Vol 47 (2) ◽  
pp. 339-346 ◽  
Author(s):  
Dean Wang ◽  
Kenneth M. Lin ◽  
Alissa J. Burge ◽  
George C. Balazs ◽  
Riley J. Williams
Keyword(s):  
Magnetic Resonance Imaging ◽  
Bone Marrow Aspirate ◽  
Osteochondral Allograft ◽  
Postoperative Phase ◽  
Resonance Imaging ◽  
Chondral Defects ◽  
Osseous Integration ◽  
Cystic Changes ◽  
Mri Scans ◽  
The Mean

Background: Poor osseous integration after fresh osteochondral allograft transplantation (OCA) may be associated with graft subsidence and subchondral bone collapse after implantation. The augmentation of OCA with bone marrow aspirate concentrate (BMAC) has been hypothesized to improve osseous incorporation of the implanted allograft. Purpose: To evaluate the effect of autogenous BMAC treatment on osseous integration at the graft-host bony interface after OCA. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective review of patients treated with OCA+BMAC or OCA alone for full-thickness chondral defects of the distal femur from March 2015 to December 2016 was conducted. Seventeen knees treated with OCA+BMAC and 16 knees treated with OCA alone underwent magnetic resonance imaging (MRI) in the early postoperative phase (mean, 6 months). Eighteen knees treated with OCA+BMAC and 16 knees treated with OCA alone underwent MRI in the late postoperative phase (mean, 12 months). Bone, cartilage, and ancillary features on MRI were graded using the Osteochondral Allograft MRI Scoring System (OCAMRISS) by a musculoskeletal radiologist blinded to the patient’s history and treatment. Results: There were no significant differences in the demographics or lesion characteristics between treatment groups in either postoperative phase. In the early postoperative phase, the mean OCAMRISS bone score was 3.0 ± 0.7 and 3.3 ± 0.7 for the OCA+BMAC group and OCA alone group, respectively ( P = .76); 71% (OCA+BMAC) and 81% (OCA alone) of MRI scans demonstrated discernible clefts at the graft-host junction ( P = .69), and 41% (OCA+BMAC) and 25% (OCA alone) of MRI scans demonstrated cystic changes at the graft and graft-host junction ( P = .46). In the late postoperative phase, the mean OCAMRISS bone score was 2.7 ± 0.8 and 2.9 ± 0.8 for the OCA+BMAC group and OCA alone group, respectively ( P = .97); 44% (OCA+BMAC) and 63% (OCA alone) of MRI scans demonstrated discernible clefts at the graft-host junction ( P = .33), and 50% (OCA+BMAC) and 31% (OCA alone) of MRI scans demonstrated the presence of cystic changes at the graft and graft-host junction ( P = .32). The mean OCAMRISS cartilage, ancillary, and total scores were not significantly different between groups in either postoperative phase. Conclusion: OCA augmented with BMAC was not associated with improved osseous integration; decreased cystic changes; or other bone, cartilage, and ancillary feature changes compared with OCA alone.

scholarly journals THU0492 MAGNETIC RESONANCE IMAGING OF THE SACROILIAC JOINTS IN PATIENTS WITH HYPERMOBILITY: A RETROSPECTIVE COHORT STUDY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 482.4-483
Author(s):  
A. Jones ◽  
C. Ciurtin ◽  
H. Kazkaz ◽  
M. Hall-Craggs
Keyword(s):  
Magnetic Resonance Imaging ◽  
Bone Marrow ◽  
Back Pain ◽  
Lumbar Spine ◽  
Magnetic Resonance ◽  
Bone Marrow Oedema ◽  
Resonance Imaging ◽  
Sacroiliac Joints ◽  
Fatty Change ◽  
Subchondral Sclerosis

Background:The incidence of inflammatory and structural lesions on magnetic resonance imaging of sacroiliac joints (MRI SIJs) in patients with hypermobility related disorders has not been fully investigated. Hypermobile patients are more susceptible to pelvic instability and biomechanical stress of the SIJs, leading to MRI SIJ changes similar to those occurring in spondyloarthritis (SpA). Patients with hypermobility and suspected SpA pose a unique challenge owing to the high prevalence of back pain in the hypermobility cohort and the absence of spinal restriction on clinical examination.Objectives:In this study, we aim to investigate the incidence of MRI SIJ lesions in patients with hypermobility.Methods:We performed a retrospective study of all patients with a confirmed diagnosis of hypermobility related disorders (including hypermobility syndrome, hypermobility spectrum disorders and Ehlers-Danlos Syndromes) referred for an MRI lumbar spine and SIJ between 2011 and 2019 to investigate long-standing back pain. MRIs were examined by a musculoskeletal (MSK) radiologist with more than 25 years of experience, who was blinded to the clinical outcome of the patients. MRI SIJs were assessed for the presence of bone marrow oedema, subchondral sclerosis, erosion, fatty change, enthesitis, ankylosis, joint fluid and capsulitis.Results:51 patients with confirmed hypermobility related disorders were referred for MRI SIJ and lumbar spine between 2011 and 2019. 3 patients demonstrated clinical features in keeping with a diagnosis of SpA and were excluded from the study. 15/48 (31.3%) of patients with hypermobility and back pain (but no clinical picture of SpA) were found to have inflammatory and/or structural lesions on MRI SIJ. The most frequent lesions were small foci of bone marrow oedema (16.6%) followed by subchondral sclerosis (12.5%) and fatty change (10.4%). The incidence of erosions was 4.2%.Conclusion:There is a relatively high incidence of inflammatory and structural lesions on MRI SIJ of patients with hypermobility. The presence of hypermobility should be taken into consideration when interpreting MRI changes in patients with suspected SpA. Further research into long-term outcomes of MRI SIJs in patients with hypermobility and back pain is required to establish the clinical significance of these findings.Disclosure of Interests: :Alexis Jones: None declared, Coziana Ciurtin Grant/research support from: Pfizer, Consultant of: Roche, Modern Biosciences, Hanadi Kazkaz: None declared, Margaret Hall-Craggs: None declared

Sign in / Sign up

Export Citation Format

Share Document