Subscribe to RSS
Please copy the URL and add it into your RSS Feed Reader.
https://www.thieme-connect.de/rss/thieme/en/10.1055-s-00000070.xml
Download PDF
Semin Musculoskelet Radiol 2011; 15(3): 221-237
DOI: 10.1055/s-0031-1278422
© Thieme Medical PublishersDOI: 10.1055/s-0031-1278422
A Practical Guide to Imaging of Cartilage Repair with Emphasis on Bone Marrow Changes
Further Information
Publication History
Publication Date:
03 June 2011 (online)
ABSTRACT
Orthopedic surgeons have multiple options available to treat articular cartilage lesions, including microfracture, osteochondral autografting, and autologous chondrocyte implantation. By having basic knowledge of these surgical procedures, radiologists can more accurately interpret imaging studies obtained after surgery. In this article, we briefly review the different types of cartilage repair procedures, their appearance on magnetic resonance imaging (MRI), and pathologic MRI findings associated with postoperative complications. We also briefly discuss advanced MRI techniques (T2 mapping, delayed gadolinium-enhanced MRI of cartilage, sodium MRI) that have been recently used to assess the biochemical composition of repair tissue matrix. MRI can accurately assess the status and health of cartilage repair tissue. By providing this information to orthopedic surgeons, radiologists can play a valuable role in the management of patients who undergo cartilage repair surgery.
KEYWORDS
Magnetic resonance imaging - cartilage repair - microfracture - osteochondral autograft - autologous chondrocyte implantation
REFERENCES
- 1 Steadman J R, Briggs K K, Rodrigo J J, Kocher M S, Gill T J, Rodkey W G. Outcomes of microfracture for traumatic chondral defects of the knee: average 11-year follow-up. Arthroscopy. 2003; 19 (5) 477-484
- 2 Steadman J R, Rodkey W G, Rodrigo J J. Microfracture: surgical technique and rehabilitation to treat chondral defects. Clin Orthop Relat Res. 2001; (391, Suppl) S362-S369
- 3 Frisbie D D, Oxford J T, Southwood L et al.. Early events in cartilage repair after subchondral bone microfracture. Clin Orthop Relat Res. 2003; (407) 215-227
- 4 Shapiro F, Koide S, Glimcher M J. Cell origin and differentiation in the repair of full-thickness defects of articular cartilage. J Bone Joint Surg Am. 1993; 75 (4) 532-553
- 5 Mankin H J. The response of articular cartilage to mechanical injury. J Bone Joint Surg Am. 1982; 64 (3) 460-466
- 6 Robinson D, Nevo Z. Articular cartilage chondrocytes are more advantageous for generating hyaline-like cartilage than mesenchymal cells isolated from microfracture repairs. Cell Tissue Bank. 2001; 2 (1) 23-30
- 7 Nehrer S, Spector M, Minas T. Histologic analysis of tissue after failed cartilage repair procedures. Clin Orthop Relat Res. 1999; 365 (365) 149-162
- 8 Blevins F T, Steadman J R, Rodrigo J J, Silliman J. Treatment of articular cartilage defects in athletes: an analysis of functional outcome and lesion appearance. Orthopedics. 1998; 21 (7) 761-767; discussion 767–768
- 9 Salter R B. The biologic concept of continuous passive motion of synovial joints. The first 18 years of basic research and its clinical application. Clin Orthop Relat Res. 1989; 242 (242) 12-25
- 10 Hangody L, Füles P. Autologous osteochondral mosaicplasty for the treatment of full-thickness defects of weight-bearing joints: ten years of experimental and clinical experience. J Bone Joint Surg Am. 2003; 85-A (Suppl 2) 25-32
- 11 Yamashita F, Sakakida K, Suzu F, Takai S. The transplantation of an autogeneic osteochondral fragment for osteochondritis dissecans of the knee. Clin Orthop Relat Res. 1985; 201 (201) 43-50
- 12 Bobić V. Arthroscopic osteochondral autograft transplantation in anterior cruciate ligament reconstruction: a preliminary clinical study. Knee Surg Sports Traumatol Arthrosc. 1996; 3 (4) 262-264
- 13 Hangody L, Kish G, Kárpáti Z, Szerb I, Udvarhelyi I. Arthroscopic autogenous osteochondral mosaicplasty for the treatment of femoral condylar articular defects. A preliminary report. Knee Surg Sports Traumatol Arthrosc. 1997; 5 (4) 262-267
- 14 Bodó G, Kaposi A D, Hangody L et al.. The surgical technique and the age of the horse both influence the outcome of mosaicplasty in a cadaver equine stifle model. Acta Vet Hung. 2001; 49 (1) 111-116
- 15 Feczkó P, Hangody L, Varga J et al.. Experimental results of donor site filling for autologous osteochondral mosaicplasty. Arthroscopy. 2003; 19 (7) 755-761
- 16 Hangody L, Kish G, Kárpáti Z, Szerb I, Eberhardt R. Treatment of osteochondritis dissecans of the talus: use of the mosaicplasty technique—a preliminary report. Foot Ankle Int. 1997; 18 (10) 628-634
- 17 Hangody L, Feczkó P, Bartha L, Bodó G, Kish G. Mosaicplasty for the treatment of articular defects of the knee and ankle. Clin Orthop Relat Res. 2001; 391 (391, Suppl) S328-S336
- 18 Yamamoto Y, Ishibashi Y, Tsuda E, Sato H, Toh S. Osteochondral autograft transplantation for osteochondritis dissecans of the elbow in juvenile baseball players: minimum 2-year follow-up. Am J Sports Med. 2006; 34 (5) 714-720
- 19 Bastian J D, Büchler L, Meyer D C, Siebenrock K A, Keel M J. Surgical hip dislocation for osteochondral transplantation as a salvage procedure for a femoral head impaction fracture. J Orthop Trauma. 2010; 24 (12) e113-e118
- 20 Ahmad C S, Cohen Z A, Levine W N, Ateshian G A, Mow V C. Biomechanical and topographic considerations for autologous osteochondral grafting in the knee. Am J Sports Med. 2001; 29 (2) 201-206
- 21 Bartz R L, Kamaric E, Noble P C, Lintner D, Bocell J. Topographic matching of selected donor and recipient sites for osteochondral autografting of the articular surface of the femoral condyles. Am J Sports Med. 2001; 29 (2) 207-212
- 22 Harris J D, Siston R A, Pan X, Flanigan D C. Autologous chondrocyte implantation: a systematic review. J Bone Joint Surg Am. 2010; 92 (12) 2220-2233
- 23 Brittberg M, Lindahl A, Nilsson A, Ohlsson C, Isaksson O, Peterson L. Treatment of deep cartilage defects in the knee with autologous chondrocyte transplantation. N Engl J Med. 1994; 331 (14) 889-895
- 24 Trice M E, Bugbee W D, Greenwald A S, Heim C S. Articular cartilage restoration: a review of currently available methods for repair
of articular cartilage defects. Paper presented at: American Academy of Orthopaedic Surgeons 76th Annual Meeting;
2009 Las Vegas, NV
Reference Ris Wihthout Link
- 25 Grande D A, Pitman M I, Peterson L, Menche D, Klein M. The repair of experimentally produced defects in rabbit articular cartilage by autologous chondrocyte transplantation. J Orthop Res. 1989; 7 (2) 208-218
- 26 King P J, Bryant T, Minas T. Autologous chondrocyte implantation for chondral defects of the knee: indications and technique. J Knee Surg. 2002; 15 (3) 177-184
- 27
Bekkers J E, Inklaar M, Saris D B.
Treatment selection in articular cartilage lesions of the knee: a systematic review.
Am J Sports Med.
2009;
37
(Suppl 1)
148S-155S
Reference Ris Wihthout Link
- 28 Micheli L J, Browne J E, Erggelet C et al.. Autologous chondrocyte implantation of the knee: multicenter experience and minimum 3-year follow-up. Clin J Sport Med. 2001; 11 (4) 223-228
- 29 Cherubino P, Grassi F A, Bulgheroni P, Ronga M. Autologous chondrocyte implantation using a bilayer collagen membrane: a preliminary report. J Orthop Surg (Hong Kong). 2003; 11 (1) 10-15
- 30 Driesang I M, Hunziker E B. Delamination rates of tissue flaps used in articular cartilage repair. J Orthop Res. 2000; 18 (6) 909-911
- 31 Minas T, Nehrer S. Current concepts in the treatment of articular cartilage defects. Orthopedics. 1997; 20 (6) 525-538
- 32 Kon E, Verdonk P, Condello V et al.. Matrix-assisted autologous chondrocyte transplantation for the repair of cartilage defects of the knee: systematic clinical data review and study quality analysis. Am J Sports Med. 2009; 37 (Suppl 1) 156S-166S
- 33 Behrens P, Bitter T, Kurz B, Russlies M. Matrix-associated autologous chondrocyte transplantation/implantation (MACT/MACI)—5-year follow-up. Knee. 2006; 13 (3) 194-202
- 34 Solchaga L A, Yoo J U, Lundberg M et al.. Hyaluronan-based polymers in the treatment of osteochondral defects. J Orthop Res. 2000; 18 (5) 773-780
- 35 Nehrer S, Domayer S, Dorotka R, Schatz K, Bindreiter U, Kotz R. Three-year clinical outcome after chondrocyte transplantation using a hyaluronan matrix for cartilage repair. Eur J Radiol. 2006; 57 (1) 3-8
- 36 Ferruzzi A, Buda R, Faldini C et al.. Autologous chondrocyte implantation in the knee joint: open compared with arthroscopic technique. Comparison at a minimum follow-up of five years. J Bone Joint Surg Am. 2008; 90 (Suppl 4) 90-101
- 37 Trattnig S, Domayer S, Welsch G W, Mosher T, Eckstein F. MR imaging of cartilage and its repair in the knee—a review. Eur Radiol. 2009; 19 (7) 1582-1594
- 38 Potter H G, Foo L F. Magnetic resonance imaging of articular cartilage: trauma, degeneration, and repair. Am J Sports Med. 2006; 34 (4) 661-677
- 39 Recht M P, Goodwin D W, Winalski C S, White L M. MRI of articular cartilage: revisiting current status and future directions. AJR Am J Roentgenol. 2005; 185 (4) 899-914
- 40 Browne J E, Branch T P. Surgical alternatives for treatment of articular cartilage lesions. J Am Acad Orthop Surg. 2000; 8 (3) 180-189
- 41 Smith G D, Taylor J, Almqvist K F et al.. Arthroscopic assessment of cartilage repair: a validation study of 2 scoring systems. Arthroscopy. 2005; 21 (12) 1462-1467
- 42 Marlovits S, Striessnig G, Resinger C T et al.. Definition of pertinent parameters for the evaluation of articular cartilage repair tissue with high-resolution magnetic resonance imaging. Eur J Radiol. 2004; 52 (3) 310-319
- 43 Marlovits S, Singer P, Zeller P, Mandl I, Haller J, Trattnig S. Magnetic resonance observation of cartilage repair tissue (MOCART) for the evaluation of autologous chondrocyte transplantation: determination of interobserver variability and correlation to clinical outcome after 2 years. Eur J Radiol. 2006; 57 (1) 16-23
- 44 Alparslan L, Winalski C S, Boutin R D, Minas T. Postoperative magnetic resonance imaging of articular cartilage repair. Semin Musculoskelet Radiol. 2001; 5 (4) 345-363
- 45 Mithoefer K, Williams III R J, Warren R F et al.. The microfracture technique for the treatment of articular cartilage lesions in the knee. A prospective cohort study. J Bone Joint Surg Am. 2005; 87 (9) 1911-1920
- 46 Brown W E, Potter H G, Marx R G, Wickiewicz T L, Warren R F. Magnetic resonance imaging appearance of cartilage repair in the knee. Clin Orthop Relat Res. 2004; 422 (422) 214-223
- 47 Link T M, Mischung J, Wörtler K, Burkart A, Rummeny E J, Imhoff A B. Normal and pathological MR findings in osteochondral autografts with longitudinal follow-up. Eur Radiol. 2006; 16 (1) 88-96
- 48 Sanders T G, Mentzer K D, Miller M D, Morrison W B, Campbell S E, Penrod B J. Autogenous osteochondral “plug” transfer for the treatment of focal chondral defects: postoperative MR appearance with clinical correlation. Skeletal Radiol. 2001; 30 (10) 570-578
- 49 Alparslan L, Minas T, Winalski C S. Magnetic resonance imaging of autologous chondrocyte implantation. Semin Ultrasound CT MR. 2001; 22 (4) 341-351
- 50 Verstraete K L, Almqvist F, Verdonk P et al.. Magnetic resonance imaging of cartilage and cartilage repair. Clin Radiol. 2004; 59 (8) 674-689
- 51
Gudas R, Kalesinskas R J, Kimtys V et al..
A prospective randomized clinical study of mosaic osteochondral autologous transplantation
versus microfracture for the treatment of osteochondral defects in the knee joint
in young athletes.
Arthroscopy.
2005;
21
(9)
1066-1075
Reference Ris Wihthout Link
- 52 Minas T, Peterson L. Advanced techniques in autologous chondrocyte transplantation. Clin Sports Med. 1999; 18 (1) 13-44, v–vi
- 53 Peterson L, Minas T, Brittberg M, Nilsson A, Sjögren-Jansson E, Lindahl A. Two- to 9-year outcome after autologous chondrocyte transplantation of the knee. Clin Orthop Relat Res. 2000; (374) 212-234
- 54 Mosher T J, Dardzinski B J. Cartilage MRI T2 relaxation time mapping: overview and applications. Semin Musculoskelet Radiol. 2004; 8 (4) 355-368
- 55 Burstein D, Gray M, Mosher T, Dardzinski B. Measures of molecular composition and structure in osteoarthritis. Radiol Clin North Am. 2009; 47 (4) 675-686
- 56 Eckstein F, Burstein D, Link T M. Quantitative MRI of cartilage and bone: degenerative changes in osteoarthritis. NMR Biomed. 2006; 19 (7) 822-854
- 57 White L M, Sussman M S, Hurtig M, Probyn L, Tomlinson G, Kandel R. Cartilage T2 assessment: differentiation of normal hyaline cartilage and reparative tissue after arthroscopic cartilage repair in equine subjects. Radiology. 2006; 241 (2) 407-414
- 58 Welsch G H, Mamisch T C, Domayer S E et al.. Cartilage T2 assessment at 3-T MR imaging: in vivo differentiation of normal hyaline cartilage from reparative tissue after two cartilage repair procedures—initial experience. Radiology. 2008; 247 (1) 154-161
- 59 Trattnig S, Mamisch T C, Welsch G H et al.. Quantitative T2 mapping of matrix-associated autologous chondrocyte transplantation at 3 Tesla: an in vivo cross-sectional study. Invest Radiol. 2007; 42 (6) 442-448
- 60 Kurkijärvi J E, Mattila L, Ojala R O et al.. Evaluation of cartilage repair in the distal femur after autologous chondrocyte transplantation using T2 relaxation time and dGEMRIC. Osteoarthritis Cartilage. 2007; 15 (4) 372-378
- 61 Giannini S, Battaglia M, Buda R, Cavallo M, Ruffilli A, Vannini F. Surgical treatment of osteochondral lesions of the talus by open-field autologous chondrocyte implantation: a 10-year follow-up clinical and magnetic resonance imaging T2-mapping evaluation. Am J Sports Med. 2009; 37 (Suppl 1) 112S-118S
- 62 Welsch G H, Mamisch T C, Zak L et al.. Evaluation of cartilage repair tissue after matrix-associated autologous chondrocyte transplantation using a hyaluronic-based or a collagen-based scaffold with morphological MOCART scoring and biochemical T2 mapping: preliminary results. Am J Sports Med. 2010; 38 (5) 934-942
- 63 Trattnig S, Mamisch T C, Pinker K et al.. Differentiating normal hyaline cartilage from post-surgical repair tissue using fast gradient echo imaging in delayed gadolinium-enhanced MRI (dGEMRIC) at 3 Tesla. Eur Radiol. 2008; 18 (6) 1251-1259
- 64 Watanabe A, Wada Y, Obata T et al.. Delayed gadolinium-enhanced MR to determine glycosaminoglycan concentration in reparative cartilage after autologous chondrocyte implantation: preliminary results. Radiology. 2006; 239 (1) 201-208
- 65 Trattnig S, Burstein D, Szomolanyi P, Pinker K, Welsch G H, Mamisch T C. T1(Gd) gives comparable information as Delta T1 relaxation rate in dGEMRIC evaluation of cartilage repair tissue. Invest Radiol. 2009; 44 (9) 598-602
- 66 Domayer S E, Trattnig S, Stelzeneder D et al.. Delayed gadolinium-enhanced MRI of cartilage in the ankle at 3 T: feasibility and preliminary results after matrix-associated autologous chondrocyte implantation. J Magn Reson Imaging. 2010; 31 (3) 732-739
- 67 Welsch G H, Mamisch T C, Hughes T et al.. In vivo biochemical 7.0 Tesla magnetic resonance: preliminary results of dGEMRIC, zonal T2, and T2* mapping of articular cartilage. Invest Radiol. 2008; 43 (9) 619-626
- 68 Vasiliadis H S, Danielson B, Ljungberg M, McKeon B, Lindahl A, Peterson L. Autologous chondrocyte implantation in cartilage lesions of the knee: long-term evaluation with magnetic resonance imaging and delayed gadolinium-enhanced magnetic resonance imaging technique. Am J Sports Med. 2010; 38 (5) 943-949
- 69 Borthakur A, Mellon E, Niyogi S, Witschey W, Kneeland J B, Reddy R. Sodium and T1rho MRI for molecular and diagnostic imaging of articular cartilage. NMR Biomed. 2006; 19 (7) 781-821
- 70 Wheaton A J, Borthakur A, Shapiro E M et al.. Proteoglycan loss in human knee cartilage: quantitation with sodium MR imaging—feasibility study. Radiology. 2004; 231 (3) 900-905
- 71 Reddy R, Insko E K, Noyszewski E A, Dandora R, Kneeland J B, Leigh J S. Sodium MRI of human articular cartilage in vivo. Magn Reson Med. 1998; 39 (5) 697-701
- 72 Trattnig S, Welsch G H, Juras V et al.. 23Na MR imaging at 7 T after knee matrix-associated autologous chondrocyte transplantation preliminary results. Radiology. 2010; 257 (1) 175-184
Christian GlaserM.D.
Department of Radiology, Center for Biomedical Imaging, NYU Langone Medical Center
660 First Ave., New York, NY 10016
Email: christian.glaser@nyumc.org