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Imaging of cartilage repair procedures.

Sanghvi D, Munshi M, Pardiwala D - Indian J Radiol Imaging (2014)

Bottom Line: The gamut of surgical techniques, normal postoperative radiological appearances, and possible complications have been described.The five common techniques of cartilage repair currently offered include bone marrow stimulation (microfracture or drilling), mosaicplasty, synthetic resorbable scaffold grafts, osteochondral allograft transplants, and autologous chondrocyte implantation (ACI).Complications of cartilage repair procedures that may be demonstrated on magnetic resonance imaging (MRI) include plug loosening, graft protuberance, graft depression, and collapse in mosaicplasty, graft hypertrophy in ACI, and immune response leading to graft rejection, which is more common with synthetic grafts and cadaveric allografts.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Kokilaben Dhirubhai Ambani Hospital, Andheri (W), Mumbai, Maharashtra, India.

ABSTRACT
The rationale for cartilage repair is to prevent precocious osteoarthritis in untreated focal cartilage injuries in the young and middle-aged population. The gamut of surgical techniques, normal postoperative radiological appearances, and possible complications have been described. An objective method of recording the quality of repair tissue is with the magnetic resonance observation of cartilage repair tissue (MOCART) score. This scoring system evaluates nine parameters that include the extent of defect filling, border zone integration, signal intensity, quality of structure and surface, subchondral bone, subchondral lamina, and records presence or absence of synovitis and adhesions. The five common techniques of cartilage repair currently offered include bone marrow stimulation (microfracture or drilling), mosaicplasty, synthetic resorbable scaffold grafts, osteochondral allograft transplants, and autologous chondrocyte implantation (ACI). Complications of cartilage repair procedures that may be demonstrated on magnetic resonance imaging (MRI) include plug loosening, graft protuberance, graft depression, and collapse in mosaicplasty, graft hypertrophy in ACI, and immune response leading to graft rejection, which is more common with synthetic grafts and cadaveric allografts.

No MeSH data available.


Related in: MedlinePlus

Osteochondral allograft transplantation. (A) Radiograph shows medial femoral condyle avascular necrosis with collapse, flattening, and deformation. (B) Photo of cadaveric allograft. (C) Arthrotomy to expose the articular defect before transplantation. (D) A size- and shape-matched sectoral osteochondral allograft has been transplanted. (E and F) Follow-up postoperative radiograph and 3D CT shows graft union and topographic restoration
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Figure 7: Osteochondral allograft transplantation. (A) Radiograph shows medial femoral condyle avascular necrosis with collapse, flattening, and deformation. (B) Photo of cadaveric allograft. (C) Arthrotomy to expose the articular defect before transplantation. (D) A size- and shape-matched sectoral osteochondral allograft has been transplanted. (E and F) Follow-up postoperative radiograph and 3D CT shows graft union and topographic restoration

Mentions: This involves the transplantation of osteochondral grafts harvested from a cadaver into the cartilage defect via an arthrotomy. This technique is indicated in large or sectoral osteochondral defects. The harvested osteochondral allograft is matched with the size and contour of the chondral defect [Figures 7 and 8]. The advantage in this technique is that the cartilage is hyaline cartilage and not just reparative fibrocartilage. Moreover, this is the only technique available to reconstruct the exact three-dimensional topography of large sectoral articular defects. However, the availability of fresh cadaveric specimens with adequate cartilage thickness remains a challenge. Other risks include transmission of disease to the recipient from the donor and immune-mediated rejection of the transplant.


Imaging of cartilage repair procedures.

Sanghvi D, Munshi M, Pardiwala D - Indian J Radiol Imaging (2014)

Osteochondral allograft transplantation. (A) Radiograph shows medial femoral condyle avascular necrosis with collapse, flattening, and deformation. (B) Photo of cadaveric allograft. (C) Arthrotomy to expose the articular defect before transplantation. (D) A size- and shape-matched sectoral osteochondral allograft has been transplanted. (E and F) Follow-up postoperative radiograph and 3D CT shows graft union and topographic restoration
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4126139&req=5

Figure 7: Osteochondral allograft transplantation. (A) Radiograph shows medial femoral condyle avascular necrosis with collapse, flattening, and deformation. (B) Photo of cadaveric allograft. (C) Arthrotomy to expose the articular defect before transplantation. (D) A size- and shape-matched sectoral osteochondral allograft has been transplanted. (E and F) Follow-up postoperative radiograph and 3D CT shows graft union and topographic restoration
Mentions: This involves the transplantation of osteochondral grafts harvested from a cadaver into the cartilage defect via an arthrotomy. This technique is indicated in large or sectoral osteochondral defects. The harvested osteochondral allograft is matched with the size and contour of the chondral defect [Figures 7 and 8]. The advantage in this technique is that the cartilage is hyaline cartilage and not just reparative fibrocartilage. Moreover, this is the only technique available to reconstruct the exact three-dimensional topography of large sectoral articular defects. However, the availability of fresh cadaveric specimens with adequate cartilage thickness remains a challenge. Other risks include transmission of disease to the recipient from the donor and immune-mediated rejection of the transplant.

Bottom Line: The gamut of surgical techniques, normal postoperative radiological appearances, and possible complications have been described.The five common techniques of cartilage repair currently offered include bone marrow stimulation (microfracture or drilling), mosaicplasty, synthetic resorbable scaffold grafts, osteochondral allograft transplants, and autologous chondrocyte implantation (ACI).Complications of cartilage repair procedures that may be demonstrated on magnetic resonance imaging (MRI) include plug loosening, graft protuberance, graft depression, and collapse in mosaicplasty, graft hypertrophy in ACI, and immune response leading to graft rejection, which is more common with synthetic grafts and cadaveric allografts.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Kokilaben Dhirubhai Ambani Hospital, Andheri (W), Mumbai, Maharashtra, India.

ABSTRACT
The rationale for cartilage repair is to prevent precocious osteoarthritis in untreated focal cartilage injuries in the young and middle-aged population. The gamut of surgical techniques, normal postoperative radiological appearances, and possible complications have been described. An objective method of recording the quality of repair tissue is with the magnetic resonance observation of cartilage repair tissue (MOCART) score. This scoring system evaluates nine parameters that include the extent of defect filling, border zone integration, signal intensity, quality of structure and surface, subchondral bone, subchondral lamina, and records presence or absence of synovitis and adhesions. The five common techniques of cartilage repair currently offered include bone marrow stimulation (microfracture or drilling), mosaicplasty, synthetic resorbable scaffold grafts, osteochondral allograft transplants, and autologous chondrocyte implantation (ACI). Complications of cartilage repair procedures that may be demonstrated on magnetic resonance imaging (MRI) include plug loosening, graft protuberance, graft depression, and collapse in mosaicplasty, graft hypertrophy in ACI, and immune response leading to graft rejection, which is more common with synthetic grafts and cadaveric allografts.

No MeSH data available.


Related in: MedlinePlus