Poor outcome after a surgically treated chondral injury on the medial femoral condyle: early evaluation with dGEMRIC and 17-year radiographic and clinical follow-up in 16 knees
Background and purpose — The optimal treatment for traumatic cartilage injuries remains unknown. Contrast-enhanced MRI of cartilage (dGEMRIC) evaluates cartilage quality and a low dGEMRIC index may predict radiographic osteoarthritis (OA). The purpose of this study was (a) to explore the results 17...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Medical Journals Sweden
2018-07-01
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| Series: | Acta Orthopaedica |
| Online Access: | http://dx.doi.org/10.1080/17453674.2018.1481304 |
| _version_ | 1798017193909157888 |
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| author | Jon Tjörnstrand Paul Neuman Björn Lundin Jonas Svensson Leif E Dahlberg Carl Johan Tiderius |
| author_facet | Jon Tjörnstrand Paul Neuman Björn Lundin Jonas Svensson Leif E Dahlberg Carl Johan Tiderius |
| author_sort | Jon Tjörnstrand |
| collection | DOAJ |
| description | Background and purpose — The optimal treatment for traumatic cartilage injuries remains unknown. Contrast-enhanced MRI of cartilage (dGEMRIC) evaluates cartilage quality and a low dGEMRIC index may predict radiographic osteoarthritis (OA). The purpose of this study was (a) to explore the results 17 years after surgical treatment of an isolated cartilage knee injury and (b) to evaluate the predictive value of dGEMRIC. Patients and methods — 16 knees with an isolated traumatic cartilage injury of the medial femoral condyle had cartilage repair surgery either by microfracture or autologous cartilage implantation. dGEMRIC of the injured knee was performed 2 years after surgery and radiographic examinations were performed 17 years after the operation. Results — Radiographic OA was present in 12 of 16 knees. Irrespective of surgical method, the dGEMRIC index was lower in repair tissue compared with adjacent cartilage in the medial compartment, 237 ms vs. 312 ms (p < 0.001), which in turn had lower value than in the non-injured lateral cartilage, 312 ms vs. 354 ms (p < 0.008). The dGEMRIC index in the cartilage adjacent to the repair tissue correlated negatively with radiographic osteophyte score, r = –0.75 (p = 0.03). Interpretation — A traumatic cartilage injury is associated with a high prevalence of OA after 17 years. The low dGEMRIC index in the repair tissue 2 years postoperatively indicates fibrocartilage of low quality. The negative correlation between the dGEMRIC index in the adjacent cartilage and future OA suggests that the quality of the surrounding cartilage influences outcome after cartilage repair surgery. |
| first_indexed | 2024-04-11T16:01:52Z |
| format | Article |
| id | doaj.art-c06b50366ae94e9f93ac5732aec347d3 |
| institution | Directory Open Access Journal |
| issn | 1745-3674 1745-3682 |
| language | English |
| last_indexed | 2024-04-11T16:01:52Z |
| publishDate | 2018-07-01 |
| publisher | Medical Journals Sweden |
| record_format | Article |
| series | Acta Orthopaedica |
| spelling | doaj.art-c06b50366ae94e9f93ac5732aec347d32022-12-22T04:14:56ZengMedical Journals SwedenActa Orthopaedica1745-36741745-36822018-07-0189443143610.1080/17453674.2018.14813041481304Poor outcome after a surgically treated chondral injury on the medial femoral condyle: early evaluation with dGEMRIC and 17-year radiographic and clinical follow-up in 16 kneesJon Tjörnstrand0Paul Neuman1Björn Lundin2Jonas Svensson3Leif E Dahlberg4Carl Johan Tiderius5Lund UniversityLund UniversityLund UniversityLund UniversityLund UniversityLund UniversityBackground and purpose — The optimal treatment for traumatic cartilage injuries remains unknown. Contrast-enhanced MRI of cartilage (dGEMRIC) evaluates cartilage quality and a low dGEMRIC index may predict radiographic osteoarthritis (OA). The purpose of this study was (a) to explore the results 17 years after surgical treatment of an isolated cartilage knee injury and (b) to evaluate the predictive value of dGEMRIC. Patients and methods — 16 knees with an isolated traumatic cartilage injury of the medial femoral condyle had cartilage repair surgery either by microfracture or autologous cartilage implantation. dGEMRIC of the injured knee was performed 2 years after surgery and radiographic examinations were performed 17 years after the operation. Results — Radiographic OA was present in 12 of 16 knees. Irrespective of surgical method, the dGEMRIC index was lower in repair tissue compared with adjacent cartilage in the medial compartment, 237 ms vs. 312 ms (p < 0.001), which in turn had lower value than in the non-injured lateral cartilage, 312 ms vs. 354 ms (p < 0.008). The dGEMRIC index in the cartilage adjacent to the repair tissue correlated negatively with radiographic osteophyte score, r = –0.75 (p = 0.03). Interpretation — A traumatic cartilage injury is associated with a high prevalence of OA after 17 years. The low dGEMRIC index in the repair tissue 2 years postoperatively indicates fibrocartilage of low quality. The negative correlation between the dGEMRIC index in the adjacent cartilage and future OA suggests that the quality of the surrounding cartilage influences outcome after cartilage repair surgery.http://dx.doi.org/10.1080/17453674.2018.1481304 |
| spellingShingle | Jon Tjörnstrand Paul Neuman Björn Lundin Jonas Svensson Leif E Dahlberg Carl Johan Tiderius Poor outcome after a surgically treated chondral injury on the medial femoral condyle: early evaluation with dGEMRIC and 17-year radiographic and clinical follow-up in 16 knees Acta Orthopaedica |
| title | Poor outcome after a surgically treated chondral injury on the medial femoral condyle: early evaluation with dGEMRIC and 17-year radiographic and clinical follow-up in 16 knees |
| title_full | Poor outcome after a surgically treated chondral injury on the medial femoral condyle: early evaluation with dGEMRIC and 17-year radiographic and clinical follow-up in 16 knees |
| title_fullStr | Poor outcome after a surgically treated chondral injury on the medial femoral condyle: early evaluation with dGEMRIC and 17-year radiographic and clinical follow-up in 16 knees |
| title_full_unstemmed | Poor outcome after a surgically treated chondral injury on the medial femoral condyle: early evaluation with dGEMRIC and 17-year radiographic and clinical follow-up in 16 knees |
| title_short | Poor outcome after a surgically treated chondral injury on the medial femoral condyle: early evaluation with dGEMRIC and 17-year radiographic and clinical follow-up in 16 knees |
| title_sort | poor outcome after a surgically treated chondral injury on the medial femoral condyle early evaluation with dgemric and 17 year radiographic and clinical follow up in 16 knees |
| url | http://dx.doi.org/10.1080/17453674.2018.1481304 |
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