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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 at 4 months, 12 months, and 39 months postoperatively. Complete incorporation of the plug into host bone was observed in greater than 60% of cases at final follow-up (≥16 months).
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Related In: Results  -  Collection


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fig5-1947603509355970: Sagittal cartilage-sensitive, fast-spin echo magnetic resonance images of a TruFit bone graft substitute plug at 4 months, 12 months, and 39 months postoperatively. Complete incorporation of the plug into host bone was observed in greater than 60% of cases at final follow-up (≥16 months).

Mentions: Linear regression and correlational analysis revealed important relationships between the measured MR parameters of the repair cartilage and preoperative, intraoperative, and postoperative variables. The presence of subchondral edema was uncommon but significantly associated with a short postoperative duration (P = 0.02). Abnormal, hyperintense signal of the repair tissue was associated with a short postoperative interval (P = 0.02) and multiple-plug configuration (P = 0.01; Figs. 1-4). Mild bony overgrowth was observed and strongly correlated with a middle position in a multiple plug configuration (P < 0.0001) and with postoperative duration greater than 16 months (P < 0.0001; Fig. 5). Depressed or proud plug morphology was associated with a short postoperative interval (P = 0.02) and large plug size (P = 0.003). Significant resorption at the plug-native bone interface was associated with older age (P = 0.01), intermediate postoperative duration (~12 months; P < 0.0001), and a single-plug configuration (P = 0.04; Fig. 3). Both incomplete fill of the defect and poor plug incorporation were associated with short to intermediate postoperative duration (P = 0.02 and P = 0.006, respectively). Poor ICRS scores of adjacent cartilage were significantly associated with the use of multiple plugs compared with a single plug to fill donor lesions (P = 0.01).


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 at 4 months, 12 months, and 39 months postoperatively. Complete incorporation of the plug into host bone was observed in greater than 60% of cases at final follow-up (≥16 months).
© Copyright Policy
Related In: Results  -  Collection

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

fig5-1947603509355970: Sagittal cartilage-sensitive, fast-spin echo magnetic resonance images of a TruFit bone graft substitute plug at 4 months, 12 months, and 39 months postoperatively. Complete incorporation of the plug into host bone was observed in greater than 60% of cases at final follow-up (≥16 months).
Mentions: Linear regression and correlational analysis revealed important relationships between the measured MR parameters of the repair cartilage and preoperative, intraoperative, and postoperative variables. The presence of subchondral edema was uncommon but significantly associated with a short postoperative duration (P = 0.02). Abnormal, hyperintense signal of the repair tissue was associated with a short postoperative interval (P = 0.02) and multiple-plug configuration (P = 0.01; Figs. 1-4). Mild bony overgrowth was observed and strongly correlated with a middle position in a multiple plug configuration (P < 0.0001) and with postoperative duration greater than 16 months (P < 0.0001; Fig. 5). Depressed or proud plug morphology was associated with a short postoperative interval (P = 0.02) and large plug size (P = 0.003). Significant resorption at the plug-native bone interface was associated with older age (P = 0.01), intermediate postoperative duration (~12 months; P < 0.0001), and a single-plug configuration (P = 0.04; Fig. 3). Both incomplete fill of the defect and poor plug incorporation were associated with short to intermediate postoperative duration (P = 0.02 and P = 0.006, respectively). Poor ICRS scores of adjacent cartilage were significantly associated with the use of multiple plugs compared with a single plug to fill donor lesions (P = 0.01).

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