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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 cartilage-sensitive, fast-spin echo magnetic resonance images of a TruFit bone graft substitute plug (BGS) at 6 months, 12 months, and 38 months postoperatively. The appearance of the plug parallels its biological incorporation, demonstrating unfavorable characteristics during the phase of resorption and early incorporation at intermediate postoperative follow-up. Resorption at the plug-native bone interface was seen in greater than 60% of TruFit BGS plugs at approximately 12 months.
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fig4-1947603509355970: Sagittal cartilage-sensitive, fast-spin echo magnetic resonance images of a TruFit bone graft substitute plug (BGS) at 6 months, 12 months, and 38 months postoperatively. The appearance of the plug parallels its biological incorporation, demonstrating unfavorable characteristics during the phase of resorption and early incorporation at intermediate postoperative follow-up. Resorption at the plug-native bone interface was seen in greater than 60% of TruFit BGS plugs at approximately 12 months.

Mentions: TruFit BGS plug appearance deteriorated on MR images by approximately 12 months postoperatively. Only 26% of plugs (12 of 46) demonstrated a flush morphology, and only 52% (24 of 46) of plugs exhibited near complete or complete fill of the donor site defect. Resorption at the interface between the plug and native bone, defined by a larger measured diameter of the nonossified plug matrix compared with the known plug size, was common and affected 61% of plugs (28 of 46) at intermediate follow-up (Fig. 3). Ninety percent of plugs (40 of 46) had hyperintense signal compared with the surrounding articular cartilage. Mild subchondral edema was observed below 15% of the plugs (7 of 46). No bony overgrowth was seen. Only 3% of the plugs demonstrated complete incorporation, while 83% (38 of 46) demonstrated partial incorporation into the native trabecular architecture (Fig. 4).


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 cartilage-sensitive, fast-spin echo magnetic resonance images of a TruFit bone graft substitute plug (BGS) at 6 months, 12 months, and 38 months postoperatively. The appearance of the plug parallels its biological incorporation, demonstrating unfavorable characteristics during the phase of resorption and early incorporation at intermediate postoperative follow-up. Resorption at the plug-native bone interface was seen in greater than 60% of TruFit BGS plugs at approximately 12 months.
© Copyright Policy
Related In: Results  -  Collection

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

fig4-1947603509355970: Sagittal cartilage-sensitive, fast-spin echo magnetic resonance images of a TruFit bone graft substitute plug (BGS) at 6 months, 12 months, and 38 months postoperatively. The appearance of the plug parallels its biological incorporation, demonstrating unfavorable characteristics during the phase of resorption and early incorporation at intermediate postoperative follow-up. Resorption at the plug-native bone interface was seen in greater than 60% of TruFit BGS plugs at approximately 12 months.
Mentions: TruFit BGS plug appearance deteriorated on MR images by approximately 12 months postoperatively. Only 26% of plugs (12 of 46) demonstrated a flush morphology, and only 52% (24 of 46) of plugs exhibited near complete or complete fill of the donor site defect. Resorption at the interface between the plug and native bone, defined by a larger measured diameter of the nonossified plug matrix compared with the known plug size, was common and affected 61% of plugs (28 of 46) at intermediate follow-up (Fig. 3). Ninety percent of plugs (40 of 46) had hyperintense signal compared with the surrounding articular cartilage. Mild subchondral edema was observed below 15% of the plugs (7 of 46). No bony overgrowth was seen. Only 3% of the plugs demonstrated complete incorporation, while 83% (38 of 46) demonstrated partial incorporation into the native trabecular architecture (Fig. 4).

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