Abstract
Purpose
This study was done to assess the progression of cartilage repair after autologous chondrocyte implantation (ACI) with magnetic resonance imaging (MRI) and to correlate the findings with the clinical outcome.
Materials and methods
Forty-one patients (mean age 30 years) affected by chondral defects of the knee (27 patients) and ankle joint (14 patients) who underwent arthroscopic autologous osteochondral grafting were studied 6 months and 1 year postoperatively with MRI. Cartilage repair after chondrocyte implantation was studied by assessing the degree of defect filling, graft integration, graft signal intensity, integrity of the subchondral lamina and trabecular oedema underneath the graft. MR findings were correlated with clinical data.
Results
Postoperative MRI evaluation at 6 months demonstrated complete filling of the osteochondral defect in 12/41 cases, complete integration in 18/41, mild hyperintensity in 28/41, intact subchondral lamina in 38/41 and trabecular oedema in 11/41. Postoperative MRI evaluation at 1 year demonstrated complete filling of the osteochondral defect in 9/41 patients, complete integration in 22/41, mild hyperintensity in 23/41, intact subchondral lamina in 36/41 and trabecular oedema in 8/41. Filling of the osteochondral defect and incomplete integration, nonintact subchondral lamina, high signal intensity and absence of oedema were found to correlate with worse clinical-functional outcomes.
Conclusions
MRI shows direct prognostic signs of the clinical outcome of ACI.
Riassunto
Obiettivo
Valutare con risonanza magnetica (RM) l’evoluzione dell’impianto di cartilagine autologa nelle lesioni condrali e correlare i dati con i risultati clinici.
Materiali e metodi
Sono state esaminate con RM a sei mesi ed un anno dall’intervento, 41 lesioni cartilaginee del ginocchio (27) e tibio-tarsiche (14), trattate per via artroscopica con impianto di condrociti autologhi su supporto tridimensionale di acido ialuronico. L’evoluzione dell’impianto è stata studiata analizzando il grado di colmatura del difetto osteocondrale, il grado di integrazione, l’intensità di segnale della cartilagine trapiantata, l’integrità della lamina corticale subcondrale e l’edema trabecolare. Tutti i dati sono stati correlati con la clinica.
Risultati
A sei mesi: completo grado di colmatura in 12/41 pazienti, integrazione completa dell’impianto in 18/41, modesta iperintensità del segnale in 28/41, lamina subcondrale intatta in 38/41, edema trabecolare in 11/41. Ad un anno: completo grado di colmatura in 9/41 pazienti, integrazione completa dell’impianto in 22/41, modesta iperintensità del segnale in 23/41, lamina subcondrale intatta in 36/41, edema trabecolare in 8/41. Il grado di colmatura e di integrazione incompleti, la lamina subcondrale non intatta, l’iperintensità del segnale e l’assenza di edema sono risultati correlare con i risultati clinico-funzionali peggiori.
Conclusioni
La valutazione RM presenta elementi prognostici in termini di buon attecchimento dell’impianto.
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Caumo, F., Russo, A., Faccioli, N. et al. Autologous chondrocyte implantation: Prospective MRI evaluation with clinical correlation. Radiol med 112, 722–731 (2007). https://doi.org/10.1007/s11547-007-0175-z
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DOI: https://doi.org/10.1007/s11547-007-0175-z