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The Maturation of Synthetic Scaffolds for Osteochondral Donor Sites of the Knee: An MRI and T2-Mapping Analysis.

Bedi A, Foo LF, Williams RJ, Potter HG, Cartilage Study Gro - Cartilage (2010)

Bottom Line: T2 values for the repair cartilage approached that of normal cartilage with increasing duration after surgery (P < 0.004), more so for single- compared with multiple-plug configurations (P = 0.03).An intermediate postoperative interval can be associated with unfavorable MRI findings.However, the plug appearance significantly improves with greater postoperative duration and has mean T2 relaxation times that approach those of normal articular cartilage.

View Article: PubMed Central - PubMed

Affiliation: Hospital for Special Surgery, New York, New York.

ABSTRACT

Objective: The purpose of this study was to analyze the morphological imaging characteristics and incorporation of TruFit bone graft substitute (BGS) plugs using cartilage-sensitive magnetic resonance imaging (MRI) and quantitative T2 mapping.

Design: Twenty-six patients (mean age, 28.72 years; range, 11-56 years) underwent osteochondral autologous transplantation (OATS) for chondral defects with filling of the knee joint donor sites using Trufit BGS plugs. The mean follow-up interval between implantation and MRI analysis was 21.3 months (range, 6-39 months). During this period, 43 cartilage-sensitive and 25 quantitative T2-mapping MRI studies were performed. The donor sites were assessed for plug and interface morphology, displacement, hypertrophy, subchondral edema, presence of bony overgrowth, percentage fill, and degree of incorporation. T2 relaxation times were measured for the superficial and deep layers of the repair tissue. A linear regression and correlational analysis was performed with Bonferroni correction, and P < 0.05 was defined as significant.

Results: Longitudinal analysis revealed favorable plug appearance at early follow-up (≤6 months), with 75% of plugs demonstrating flush morphology and 78% demonstrating near complete to complete fill. Plug appearance deteriorated at intermediate follow-up (~12 months), with only 26% of plugs demonstrating flush morphology and 52% with near complete or complete fill. Plug appearance substantially improved with longer follow-up (≥16 months), with 70% of plugs demonstrating flush morphology and 90% demonstrating near complete or complete fill. Interface resorption was common at ~12 months (P < 0.0001) and was associated with older age (P = 0.01) or a single-plug configuration (P = 0.04). T2 values for the repair cartilage approached that of normal cartilage with increasing duration after surgery (P < 0.004), more so for single- compared with multiple-plug configurations (P = 0.03).

Conclusions: The Trufit BGS plug demonstrates a predictable pattern of postoperative maturation on MRI images that parallels its biological incorporation. An intermediate postoperative interval can be associated with unfavorable MRI findings. However, the plug appearance significantly improves with greater postoperative duration and has mean T2 relaxation times that approach those of normal articular cartilage.

No MeSH data available.


Related in: MedlinePlus

Sagittal fat-suppressed cartilage-sensitive, fast-spin echo magnetic resonance images of a TruFit bone graft substitute plug at 6 months, 12 months, and 25 months postoperatively demonstrates absence of adjacent bone marrow edema pattern, at even 6 months postoperatively. Images also demonstrate no displacement, effusion, or an adverse synovial reaction.
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fig1-1947603509355970: Sagittal fat-suppressed cartilage-sensitive, fast-spin echo magnetic resonance images of a TruFit bone graft substitute plug at 6 months, 12 months, and 25 months postoperatively demonstrates absence of adjacent bone marrow edema pattern, at even 6 months postoperatively. Images also demonstrate no displacement, effusion, or an adverse synovial reaction.

Mentions: Analysis of the TruFit BGS plugs on MR images in multiple planes on all sequences revealed no evidence of plug displacement or hypertrophy at the donor sites for all knees across all time points. Fat pad scarring was minimal or mild in all cases. Similarly, no evidence of a inflammatory synovitis or effusion was appreciated on any images throughout the period of study (Fig. 1).


The Maturation of Synthetic Scaffolds for Osteochondral Donor Sites of the Knee: An MRI and T2-Mapping Analysis.

Bedi A, Foo LF, Williams RJ, Potter HG, Cartilage Study Gro - Cartilage (2010)

Sagittal fat-suppressed cartilage-sensitive, fast-spin echo magnetic resonance images of a TruFit bone graft substitute plug at 6 months, 12 months, and 25 months postoperatively demonstrates absence of adjacent bone marrow edema pattern, at even 6 months postoperatively. Images also demonstrate no displacement, effusion, or an adverse synovial reaction.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4440610&req=5

fig1-1947603509355970: Sagittal fat-suppressed cartilage-sensitive, fast-spin echo magnetic resonance images of a TruFit bone graft substitute plug at 6 months, 12 months, and 25 months postoperatively demonstrates absence of adjacent bone marrow edema pattern, at even 6 months postoperatively. Images also demonstrate no displacement, effusion, or an adverse synovial reaction.
Mentions: Analysis of the TruFit BGS plugs on MR images in multiple planes on all sequences revealed no evidence of plug displacement or hypertrophy at the donor sites for all knees across all time points. Fat pad scarring was minimal or mild in all cases. Similarly, no evidence of a inflammatory synovitis or effusion was appreciated on any images throughout the period of study (Fig. 1).

Bottom Line: T2 values for the repair cartilage approached that of normal cartilage with increasing duration after surgery (P < 0.004), more so for single- compared with multiple-plug configurations (P = 0.03).An intermediate postoperative interval can be associated with unfavorable MRI findings.However, the plug appearance significantly improves with greater postoperative duration and has mean T2 relaxation times that approach those of normal articular cartilage.

View Article: PubMed Central - PubMed

Affiliation: Hospital for Special Surgery, New York, New York.

ABSTRACT

Objective: The purpose of this study was to analyze the morphological imaging characteristics and incorporation of TruFit bone graft substitute (BGS) plugs using cartilage-sensitive magnetic resonance imaging (MRI) and quantitative T2 mapping.

Design: Twenty-six patients (mean age, 28.72 years; range, 11-56 years) underwent osteochondral autologous transplantation (OATS) for chondral defects with filling of the knee joint donor sites using Trufit BGS plugs. The mean follow-up interval between implantation and MRI analysis was 21.3 months (range, 6-39 months). During this period, 43 cartilage-sensitive and 25 quantitative T2-mapping MRI studies were performed. The donor sites were assessed for plug and interface morphology, displacement, hypertrophy, subchondral edema, presence of bony overgrowth, percentage fill, and degree of incorporation. T2 relaxation times were measured for the superficial and deep layers of the repair tissue. A linear regression and correlational analysis was performed with Bonferroni correction, and P < 0.05 was defined as significant.

Results: Longitudinal analysis revealed favorable plug appearance at early follow-up (≤6 months), with 75% of plugs demonstrating flush morphology and 78% demonstrating near complete to complete fill. Plug appearance deteriorated at intermediate follow-up (~12 months), with only 26% of plugs demonstrating flush morphology and 52% with near complete or complete fill. Plug appearance substantially improved with longer follow-up (≥16 months), with 70% of plugs demonstrating flush morphology and 90% demonstrating near complete or complete fill. Interface resorption was common at ~12 months (P < 0.0001) and was associated with older age (P = 0.01) or a single-plug configuration (P = 0.04). T2 values for the repair cartilage approached that of normal cartilage with increasing duration after surgery (P < 0.004), more so for single- compared with multiple-plug configurations (P = 0.03).

Conclusions: The Trufit BGS plug demonstrates a predictable pattern of postoperative maturation on MRI images that parallels its biological incorporation. An intermediate postoperative interval can be associated with unfavorable MRI findings. However, the plug appearance significantly improves with greater postoperative duration and has mean T2 relaxation times that approach those of normal articular cartilage.

No MeSH data available.


Related in: MedlinePlus