Cartilage T 2 Relaxation Times and Subchondral Trabecular Bone Parameters Predict Morphological Outcome After Matrix-Associated Autologous Chondrocyte Implantation With Autologous Bone Grafting
Quantitative magnetic resonance (MR) imaging techniques are established for evaluation of cartilage composition and trabecular bone microstructure at the knee. It remains unclear whether quantitative MR parameters predict the midterm morphological outcome after matrix-associated chondrocyte implanta...
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| Veröffentlicht in: | The American journal of sports medicine 2020-12, Vol.48 (14), p.3573-3585 |
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| creator | Gersing, Alexandra S Holwein, Christian Suchowierski, Joachim Feuerriegel, Georg Gassert, Florian T Baum, Thomas Karampinos, Dimitrios C Schwaiger, Benedikt J Makowski, Marcus R Burgkart, Rainer Woertler, Klaus Imhoff, Andreas B Jungmann, Pia M |
| description | Quantitative magnetic resonance (MR) imaging techniques are established for evaluation of cartilage composition and trabecular bone microstructure at the knee. It remains unclear whether quantitative MR parameters predict the midterm morphological outcome after matrix-associated chondrocyte implantation (MACI) with autologous bone grafting (ABG).
To assess longitudinal changes and associations of the biochemical composition of cartilage repair tissue, the subchondral bone architecture, and morphological knee joint abnormalities on 3-T MR imaging after MACI with ABG at the knee.
Case series; Level of evidence, 4.
Knees of 18 patients (28.7 ± 8.4 years [mean ± SD]; 5 women) were examined preoperatively and 3, 6, 12, and 24 months after MACI and ABG using 3-T MR imaging. Cartilage composition was assessed using T
relaxation time measurements. Subchondral bone microstructure was quantified using a 3-dimensional phase-cycled balanced steady-state free precision sequence. Trabecular bone parameters were calculated using a dual threshold algorithm (apparent bone fraction, apparent trabecular number, and apparent trabecular separation). Morphological abnormalities were assessed using the MOCART (magnetic resonace observation of cartilage repair tissue) score, the WORMS (Whole-Organ Magnetic Resonance Imaging Score), and the CROAKS (Cartilage Repair Osteoarthritis Knee Score). Clinical symptoms were assessed using the Tegner activity and Lysholm knee scores. Statistical analyses were performed by using multiple linear regression analysis.
Total WORMS (
= .02) and MOCART (
= .001) scores significantly improved over 24 months after MACI. Clinical symptoms were significantly associated with the presence of bone marrow edema pattern abnormalities 24 months after surgery (
= .035). Overall there was a good to excellent radiological outcome found after 24 months (MOCART score, 88.8 ± 10.1). Cartilage repair T
values significantly decreased between 12 and 24 months after MACI (
= .009). Lower global T
values after 3 months were significantly associated with better MOCART scores after 24 months (
= .04). Moreover, trabecular bone parameters after 3 months were significantly associated with the total WORMS after 24 months (apparent bone fraction,
= .048; apparent trabecular number,
= .013; apparent trabecular separation,
= .013).
After MACI with ABG, early postoperative quantitative assessment of biochemical composition of cartilage and microstructure of subchondral bone ma |
| doi_str_mv | 10.1177/0363546520965987 |
| format | Article |
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To assess longitudinal changes and associations of the biochemical composition of cartilage repair tissue, the subchondral bone architecture, and morphological knee joint abnormalities on 3-T MR imaging after MACI with ABG at the knee.
Case series; Level of evidence, 4.
Knees of 18 patients (28.7 ± 8.4 years [mean ± SD]; 5 women) were examined preoperatively and 3, 6, 12, and 24 months after MACI and ABG using 3-T MR imaging. Cartilage composition was assessed using T
relaxation time measurements. Subchondral bone microstructure was quantified using a 3-dimensional phase-cycled balanced steady-state free precision sequence. Trabecular bone parameters were calculated using a dual threshold algorithm (apparent bone fraction, apparent trabecular number, and apparent trabecular separation). Morphological abnormalities were assessed using the MOCART (magnetic resonace observation of cartilage repair tissue) score, the WORMS (Whole-Organ Magnetic Resonance Imaging Score), and the CROAKS (Cartilage Repair Osteoarthritis Knee Score). Clinical symptoms were assessed using the Tegner activity and Lysholm knee scores. Statistical analyses were performed by using multiple linear regression analysis.
Total WORMS (
= .02) and MOCART (
= .001) scores significantly improved over 24 months after MACI. Clinical symptoms were significantly associated with the presence of bone marrow edema pattern abnormalities 24 months after surgery (
= .035). Overall there was a good to excellent radiological outcome found after 24 months (MOCART score, 88.8 ± 10.1). Cartilage repair T
values significantly decreased between 12 and 24 months after MACI (
= .009). Lower global T
values after 3 months were significantly associated with better MOCART scores after 24 months (
= .04). Moreover, trabecular bone parameters after 3 months were significantly associated with the total WORMS after 24 months (apparent bone fraction,
= .048; apparent trabecular number,
= .013; apparent trabecular separation,
= .013).
After MACI with ABG, early postoperative quantitative assessment of biochemical composition of cartilage and microstructure of subchondral bone may predict the outcome after 24 months. The perioperative global joint cartilage matrix quality is essential for proper proliferation of the repair tissue, reflected by MOCART scores. The subchondral bone quality of the ABG site is essential for proper maturation of the cartilage repair tissue, reflected by cartilage T
values.</description><identifier>ISSN: 0363-5465</identifier><identifier>EISSN: 1552-3365</identifier><identifier>DOI: 10.1177/0363546520965987</identifier><identifier>PMID: 33200942</identifier><language>eng</language><publisher>United States</publisher><subject>Adult ; Bone Transplantation ; Cancellous Bone - diagnostic imaging ; Cancellous Bone - surgery ; Cartilage, Articular - diagnostic imaging ; Cartilage, Articular - surgery ; Chondrocytes - transplantation ; Female ; Follow-Up Studies ; Humans ; Knee Joint - diagnostic imaging ; Knee Joint - surgery ; Magnetic Resonance Imaging ; Male ; Transplantation, Autologous ; Treatment Outcome ; Young Adult</subject><ispartof>The American journal of sports medicine, 2020-12, Vol.48 (14), p.3573-3585</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c196t-36275ce4ac20a07ed8a3762435b9976eebda675c1437f04123557dd0278d477a3</citedby><cites>FETCH-LOGICAL-c196t-36275ce4ac20a07ed8a3762435b9976eebda675c1437f04123557dd0278d477a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33200942$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gersing, Alexandra S</creatorcontrib><creatorcontrib>Holwein, Christian</creatorcontrib><creatorcontrib>Suchowierski, Joachim</creatorcontrib><creatorcontrib>Feuerriegel, Georg</creatorcontrib><creatorcontrib>Gassert, Florian T</creatorcontrib><creatorcontrib>Baum, Thomas</creatorcontrib><creatorcontrib>Karampinos, Dimitrios C</creatorcontrib><creatorcontrib>Schwaiger, Benedikt J</creatorcontrib><creatorcontrib>Makowski, Marcus R</creatorcontrib><creatorcontrib>Burgkart, Rainer</creatorcontrib><creatorcontrib>Woertler, Klaus</creatorcontrib><creatorcontrib>Imhoff, Andreas B</creatorcontrib><creatorcontrib>Jungmann, Pia M</creatorcontrib><title>Cartilage T 2 Relaxation Times and Subchondral Trabecular Bone Parameters Predict Morphological Outcome After Matrix-Associated Autologous Chondrocyte Implantation With Autologous Bone Grafting</title><title>The American journal of sports medicine</title><addtitle>Am J Sports Med</addtitle><description>Quantitative magnetic resonance (MR) imaging techniques are established for evaluation of cartilage composition and trabecular bone microstructure at the knee. It remains unclear whether quantitative MR parameters predict the midterm morphological outcome after matrix-associated chondrocyte implantation (MACI) with autologous bone grafting (ABG).
To assess longitudinal changes and associations of the biochemical composition of cartilage repair tissue, the subchondral bone architecture, and morphological knee joint abnormalities on 3-T MR imaging after MACI with ABG at the knee.
Case series; Level of evidence, 4.
Knees of 18 patients (28.7 ± 8.4 years [mean ± SD]; 5 women) were examined preoperatively and 3, 6, 12, and 24 months after MACI and ABG using 3-T MR imaging. Cartilage composition was assessed using T
relaxation time measurements. Subchondral bone microstructure was quantified using a 3-dimensional phase-cycled balanced steady-state free precision sequence. Trabecular bone parameters were calculated using a dual threshold algorithm (apparent bone fraction, apparent trabecular number, and apparent trabecular separation). Morphological abnormalities were assessed using the MOCART (magnetic resonace observation of cartilage repair tissue) score, the WORMS (Whole-Organ Magnetic Resonance Imaging Score), and the CROAKS (Cartilage Repair Osteoarthritis Knee Score). Clinical symptoms were assessed using the Tegner activity and Lysholm knee scores. Statistical analyses were performed by using multiple linear regression analysis.
Total WORMS (
= .02) and MOCART (
= .001) scores significantly improved over 24 months after MACI. Clinical symptoms were significantly associated with the presence of bone marrow edema pattern abnormalities 24 months after surgery (
= .035). Overall there was a good to excellent radiological outcome found after 24 months (MOCART score, 88.8 ± 10.1). Cartilage repair T
values significantly decreased between 12 and 24 months after MACI (
= .009). Lower global T
values after 3 months were significantly associated with better MOCART scores after 24 months (
= .04). Moreover, trabecular bone parameters after 3 months were significantly associated with the total WORMS after 24 months (apparent bone fraction,
= .048; apparent trabecular number,
= .013; apparent trabecular separation,
= .013).
After MACI with ABG, early postoperative quantitative assessment of biochemical composition of cartilage and microstructure of subchondral bone may predict the outcome after 24 months. The perioperative global joint cartilage matrix quality is essential for proper proliferation of the repair tissue, reflected by MOCART scores. The subchondral bone quality of the ABG site is essential for proper maturation of the cartilage repair tissue, reflected by cartilage T
values.</description><subject>Adult</subject><subject>Bone Transplantation</subject><subject>Cancellous Bone - diagnostic imaging</subject><subject>Cancellous Bone - surgery</subject><subject>Cartilage, Articular - diagnostic imaging</subject><subject>Cartilage, Articular - surgery</subject><subject>Chondrocytes - transplantation</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Knee Joint - diagnostic imaging</subject><subject>Knee Joint - surgery</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Transplantation, Autologous</subject><subject>Treatment Outcome</subject><subject>Young Adult</subject><issn>0363-5465</issn><issn>1552-3365</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkc1u2zAQhImiQe2mvfdU8AXU8kckraNrNE4ABw4SFz0aK3Jls5BEg6QA5_H6ZvFPEgQ57WHm21nsEPKNsx-cG_OTSS1VqZVglVbVxHwgY66UKKTU6iMZH-XiqI_I55T-Mca40ZNPZCSlYKwqxZj8n0HMvoUN0hUV9B5b2EP2oacr32Gi0Dv6MNR2G3oXoaWrCDXaoYVIf4Ue6R1E6DBjTPQuovM209sQd9vQho23B2A5ZBs6pNPmYKK3kKPfF9OUgvWQ0dHpkI_eMCQ6O4UE-5iR3nS7Fvp8PuWvz9u3xlPyPEKTfb_5Qi4aaBN-fZ6X5M_V79Xsulgs5zez6aKwvNK5kFoYZbEEKxgwg24C0mhRSlVXldGItQN9cPBSmoaVXEiljHNMmIkrjQF5Sdh5r40hpYjNehd9B_Fxzdn62Mb6fRsH5PsZ2Q11h-4VeHm_fAKmeojL</recordid><startdate>202012</startdate><enddate>202012</enddate><creator>Gersing, Alexandra S</creator><creator>Holwein, Christian</creator><creator>Suchowierski, Joachim</creator><creator>Feuerriegel, Georg</creator><creator>Gassert, Florian T</creator><creator>Baum, Thomas</creator><creator>Karampinos, Dimitrios C</creator><creator>Schwaiger, Benedikt J</creator><creator>Makowski, Marcus R</creator><creator>Burgkart, Rainer</creator><creator>Woertler, Klaus</creator><creator>Imhoff, Andreas B</creator><creator>Jungmann, Pia M</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>202012</creationdate><title>Cartilage T 2 Relaxation Times and Subchondral Trabecular Bone Parameters Predict Morphological Outcome After Matrix-Associated Autologous Chondrocyte Implantation With Autologous Bone Grafting</title><author>Gersing, Alexandra S ; Holwein, Christian ; Suchowierski, Joachim ; Feuerriegel, Georg ; Gassert, Florian T ; Baum, Thomas ; Karampinos, Dimitrios C ; Schwaiger, Benedikt J ; Makowski, Marcus R ; Burgkart, Rainer ; Woertler, Klaus ; Imhoff, Andreas B ; Jungmann, Pia M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c196t-36275ce4ac20a07ed8a3762435b9976eebda675c1437f04123557dd0278d477a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Bone Transplantation</topic><topic>Cancellous Bone - diagnostic imaging</topic><topic>Cancellous Bone - surgery</topic><topic>Cartilage, Articular - diagnostic imaging</topic><topic>Cartilage, Articular - surgery</topic><topic>Chondrocytes - transplantation</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Knee Joint - diagnostic imaging</topic><topic>Knee Joint - surgery</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Transplantation, Autologous</topic><topic>Treatment Outcome</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gersing, Alexandra S</creatorcontrib><creatorcontrib>Holwein, Christian</creatorcontrib><creatorcontrib>Suchowierski, Joachim</creatorcontrib><creatorcontrib>Feuerriegel, Georg</creatorcontrib><creatorcontrib>Gassert, Florian T</creatorcontrib><creatorcontrib>Baum, Thomas</creatorcontrib><creatorcontrib>Karampinos, Dimitrios C</creatorcontrib><creatorcontrib>Schwaiger, Benedikt J</creatorcontrib><creatorcontrib>Makowski, Marcus R</creatorcontrib><creatorcontrib>Burgkart, Rainer</creatorcontrib><creatorcontrib>Woertler, Klaus</creatorcontrib><creatorcontrib>Imhoff, Andreas B</creatorcontrib><creatorcontrib>Jungmann, Pia M</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>The American journal of sports medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gersing, Alexandra S</au><au>Holwein, Christian</au><au>Suchowierski, Joachim</au><au>Feuerriegel, Georg</au><au>Gassert, Florian T</au><au>Baum, Thomas</au><au>Karampinos, Dimitrios C</au><au>Schwaiger, Benedikt J</au><au>Makowski, Marcus R</au><au>Burgkart, Rainer</au><au>Woertler, Klaus</au><au>Imhoff, Andreas B</au><au>Jungmann, Pia M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cartilage T 2 Relaxation Times and Subchondral Trabecular Bone Parameters Predict Morphological Outcome After Matrix-Associated Autologous Chondrocyte Implantation With Autologous Bone Grafting</atitle><jtitle>The American journal of sports medicine</jtitle><addtitle>Am J Sports Med</addtitle><date>2020-12</date><risdate>2020</risdate><volume>48</volume><issue>14</issue><spage>3573</spage><epage>3585</epage><pages>3573-3585</pages><issn>0363-5465</issn><eissn>1552-3365</eissn><abstract>Quantitative magnetic resonance (MR) imaging techniques are established for evaluation of cartilage composition and trabecular bone microstructure at the knee. It remains unclear whether quantitative MR parameters predict the midterm morphological outcome after matrix-associated chondrocyte implantation (MACI) with autologous bone grafting (ABG).
To assess longitudinal changes and associations of the biochemical composition of cartilage repair tissue, the subchondral bone architecture, and morphological knee joint abnormalities on 3-T MR imaging after MACI with ABG at the knee.
Case series; Level of evidence, 4.
Knees of 18 patients (28.7 ± 8.4 years [mean ± SD]; 5 women) were examined preoperatively and 3, 6, 12, and 24 months after MACI and ABG using 3-T MR imaging. Cartilage composition was assessed using T
relaxation time measurements. Subchondral bone microstructure was quantified using a 3-dimensional phase-cycled balanced steady-state free precision sequence. Trabecular bone parameters were calculated using a dual threshold algorithm (apparent bone fraction, apparent trabecular number, and apparent trabecular separation). Morphological abnormalities were assessed using the MOCART (magnetic resonace observation of cartilage repair tissue) score, the WORMS (Whole-Organ Magnetic Resonance Imaging Score), and the CROAKS (Cartilage Repair Osteoarthritis Knee Score). Clinical symptoms were assessed using the Tegner activity and Lysholm knee scores. Statistical analyses were performed by using multiple linear regression analysis.
Total WORMS (
= .02) and MOCART (
= .001) scores significantly improved over 24 months after MACI. Clinical symptoms were significantly associated with the presence of bone marrow edema pattern abnormalities 24 months after surgery (
= .035). Overall there was a good to excellent radiological outcome found after 24 months (MOCART score, 88.8 ± 10.1). Cartilage repair T
values significantly decreased between 12 and 24 months after MACI (
= .009). Lower global T
values after 3 months were significantly associated with better MOCART scores after 24 months (
= .04). Moreover, trabecular bone parameters after 3 months were significantly associated with the total WORMS after 24 months (apparent bone fraction,
= .048; apparent trabecular number,
= .013; apparent trabecular separation,
= .013).
After MACI with ABG, early postoperative quantitative assessment of biochemical composition of cartilage and microstructure of subchondral bone may predict the outcome after 24 months. The perioperative global joint cartilage matrix quality is essential for proper proliferation of the repair tissue, reflected by MOCART scores. The subchondral bone quality of the ABG site is essential for proper maturation of the cartilage repair tissue, reflected by cartilage T
values.</abstract><cop>United States</cop><pmid>33200942</pmid><doi>10.1177/0363546520965987</doi><tpages>13</tpages></addata></record> |
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| identifier | ISSN: 0363-5465 |
| ispartof | The American journal of sports medicine, 2020-12, Vol.48 (14), p.3573-3585 |
| issn | 0363-5465 1552-3365 |
| language | eng |
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| source | SAGE Publications; MEDLINE; Alma/SFX Local Collection |
| subjects | Adult Bone Transplantation Cancellous Bone - diagnostic imaging Cancellous Bone - surgery Cartilage, Articular - diagnostic imaging Cartilage, Articular - surgery Chondrocytes - transplantation Female Follow-Up Studies Humans Knee Joint - diagnostic imaging Knee Joint - surgery Magnetic Resonance Imaging Male Transplantation, Autologous Treatment Outcome Young Adult |
| title | Cartilage T 2 Relaxation Times and Subchondral Trabecular Bone Parameters Predict Morphological Outcome After Matrix-Associated Autologous Chondrocyte Implantation With Autologous Bone Grafting |
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