Assessment of articular cartilage repair tissue after matrix-associated autologous chondrocyte transplantation or the microfracture technique in the ankle joint using diffusion-weighted imaging at 3 Tesla

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• 作者：S. Apprich^&dagger ; ; S. Trattnig^&dagger ; ; G.H. Welsch^&dagger ; ; ^&Dagger ; ; I.M. Noebauer-Huhmann^&dagger ; ; M. Sokolwski^§ ; ; C. Hirschfeld^§ ; ; D. Stelzeneder^&dagger ; ; S. Domayer^§ ; ; ^{stephan.domayer@meduniwien.ac.at}
• 关键词：MRI ; Diffusion-weighted imaging ; Ankle ; MACT ; Microfracture ; 3 T
• 刊名：Osteoarthritis and Cartilage
• 出版年：2012
• 期刊代码：249_10634584
• 类别：med
• 出版时间：July, 2012
• 卷：20
• 期：7
• 页码：703-711
• 文件大小：759 K

摘要

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Summary

Objective

The objective was to compare patients after matrix-associated autologous chondrocyte transplantation (MACT) and microfracture therapy (MFX) of the talus using diffusion-weighted imaging (DWI), with morphological and clinical scoring.

Materials and methods

Twenty patients treated with MACT or MFX (10 per group) were examined using 3聽T magnetic resonance imaging (MRI) at 48聽卤聽21.5 and 59.6聽卤聽23 months after surgery, respectively. For comparability, patients from each group were matched by age, body mass index, and follow-up. American Orthopaedic Foot and Ankle Society (AOFAS) score served as clinical assessment tool pre- and postoperatively. DWI was obtained using a partially balanced, steady-state gradient echo pulse sequence, as well as the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score, based on a 2D proton density-weighted turbo spin-echo sequence and a 3D isotropic true fast imaging with steady-state precession sequence. Semi-quantitative diffusion quotients were calculated after region of interest analysis of repair tissue (RT) and healthy control cartilage, and compared among both groups.

Results

The mean AOFAS score improved significantly (P聽=聽0.001) for both groups (MACT: 48.8聽卤聽20.4-83.6聽卤聽9.7; MFX: 44.3聽卤聽16.5-77.6聽卤聽13.2). No differences in the AOFAS (P聽=聽0.327) and MOCART (P聽=聽0.720) score were observed between MACT and MFX postoperatively. DWI distinguished between healthy cartilage and cartilage RT in the MFX group (P聽=聽0.016), but not after MACT treatment (P聽=聽0.105). Significant correlations were found between MOCART score and DWI index after MFX (Pearson: 鈭?.648; P聽=聽0.043), and between the diffusivity and longer follow-up interval in MACT group (Pearson: 鈭?.647, P聽=聽0.043).

Conclusion

Whereas conventional scores reveal a similar outcome after MACT or MFX treatment in the ankle joint, DWI was able to distinguish between different RT qualities, as reported histologically for these diverse surgical procedures.