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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

Axial quantitative T2 mapping of a trochlear TruFit bone graft substitute plug at 8 months, 13 months, and 27 months postoperatively. T2 relaxation times (milliseconds) for the superficial and deep cartilage layers of the central and peripheral plug demonstrated significant shortening with increasing duration after surgery (P < 0.004). These values approached but always remained prolonged compared with those of normal articular cartilage by final follow-up evaluation.Note: Image adapted with permission from Potter HG, Chong LR, Sneag DB. Magnetic resonance imaging of cartilage repair. Sports Med Arthrosc Rev. 2008 Dec 16(4):236-45.
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fig7-1947603509355970: Axial quantitative T2 mapping of a trochlear TruFit bone graft substitute plug at 8 months, 13 months, and 27 months postoperatively. T2 relaxation times (milliseconds) for the superficial and deep cartilage layers of the central and peripheral plug demonstrated significant shortening with increasing duration after surgery (P < 0.004). These values approached but always remained prolonged compared with those of normal articular cartilage by final follow-up evaluation.Note: Image adapted with permission from Potter HG, Chong LR, Sneag DB. Magnetic resonance imaging of cartilage repair. Sports Med Arthrosc Rev. 2008 Dec 16(4):236-45.

Mentions: T2 relaxation times (milliseconds) for the superficial and deep cartilage layers of the central and peripheral plug demonstrated significant shortening with increasing duration after surgery (P < 0.004; Figs. 6and7). More stratified T2 repair tissue with shorter values appears at the area of peripheral integration rather than the subchondral repair tissue. These values approached but always remained prolonged compared with those of normal articular cartilage by final interval follow-up evaluation. T2 relaxation times of the superficial plug-native cartilage interface were closer to native cartilage in single- compared with multiple-plug configurations (P = 0.03; Figs. 6and7).


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)

Axial quantitative T2 mapping of a trochlear TruFit bone graft substitute plug at 8 months, 13 months, and 27 months postoperatively. T2 relaxation times (milliseconds) for the superficial and deep cartilage layers of the central and peripheral plug demonstrated significant shortening with increasing duration after surgery (P < 0.004). These values approached but always remained prolonged compared with those of normal articular cartilage by final follow-up evaluation.Note: Image adapted with permission from Potter HG, Chong LR, Sneag DB. Magnetic resonance imaging of cartilage repair. Sports Med Arthrosc Rev. 2008 Dec 16(4):236-45.
© Copyright Policy
Related In: Results  -  Collection

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

fig7-1947603509355970: Axial quantitative T2 mapping of a trochlear TruFit bone graft substitute plug at 8 months, 13 months, and 27 months postoperatively. T2 relaxation times (milliseconds) for the superficial and deep cartilage layers of the central and peripheral plug demonstrated significant shortening with increasing duration after surgery (P < 0.004). These values approached but always remained prolonged compared with those of normal articular cartilage by final follow-up evaluation.Note: Image adapted with permission from Potter HG, Chong LR, Sneag DB. Magnetic resonance imaging of cartilage repair. Sports Med Arthrosc Rev. 2008 Dec 16(4):236-45.
Mentions: T2 relaxation times (milliseconds) for the superficial and deep cartilage layers of the central and peripheral plug demonstrated significant shortening with increasing duration after surgery (P < 0.004; Figs. 6and7). More stratified T2 repair tissue with shorter values appears at the area of peripheral integration rather than the subchondral repair tissue. These values approached but always remained prolonged compared with those of normal articular cartilage by final interval follow-up evaluation. T2 relaxation times of the superficial plug-native cartilage interface were closer to native cartilage in single- compared with multiple-plug configurations (P = 0.03; Figs. 6and7).

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