Postoperative Magnetic Resonance Imaging of Articular Cartilage Repair

Leyla Alparslan; Carl S. Winalski; Robert D. Boutin; Tom Minas

doi:10.1055/s-2001-19044

Seminars in Musculoskeletal Radiology, Table of Contents

Semin Musculoskelet Radiol 2001; 05(4): 345-364
DOI: 10.1055/s-2001-19044

Postoperative Magnetic Resonance Imaging of Articular Cartilage Repair

Leyla Alparslan¹ , Carl S. Winalski² , Robert D. Boutin³ , Tom Minas⁴

¹Department of Radiology, Harvard Medical School, Brigham and Women's Hospital, Boston, MA
²Department of Radiology, Harvard Medical School, and Cartilage Repair Center, Brigham and Women's Hospital, Boston, MA
³Med-Tel International, McClean, VA
⁴Department of Orthopedic Surgery, Harvard Medical School, and Cartilage Repair Center, Brigham and Women's Hospital, Boston, MA

Abstract

ABSTRACT

The treatment of articular cartilage injuries remains a challenge because cartilage has a limited capacity for spontaneous repair. Over the past decade, a number of surgical interventions have been developed to produce a durable repair. This article reviews the available treatment options, including their indications, technique, and clinical results, and illustrates the MR imaging appearance of normal repair sites and postoperative complications.

KEYWORD

Articular cartilage - magnetic resonance imaging - cartilage repair - cartilage transplantation - autologous chondrocyte transplantation - osteochondral transplantation - microfracture

Full Text

References

REFERENCES

1 Curl W W, Krome J, Gordon E S, Rushing J, Smith B P, Poehling G G. Cartilage injuries: a review of 31,516 knee arthroscopies. Arthroscopy . 1997; 13 456-460
2 Buckwalter J A. Articular cartilage: injuries and potential for healing. J Orthop Sports Phys Ther . 1998; 28 192-202
3 Browne J E, Branch T P. Surgical alternatives for treatment of articular cartilage lesions. J Am Acad Orthop Surg . 2000; 8 180-189
4 Bobic V, Noble J. Articular cartilage-to repair or not to repair. J Bone Joint Surg Br . 2000; 82 165-166
5 Nehrer S, Spector M, Minas T. Histologic analysis of tissue after failed cartilage repair procedures. Clin Orthopaed Relat Res . 1999; 365 149-162
6 Bobic V, Morgan C D, Carter T. Osteochondral autologous graft transfer. Op Tech Sports Med . 2000; 8 168-178
7 Minas T. The role of cartilage repair techniques, including chondrocyte transplantation, in focal chondral knee damage. AAOS Instructional Course Lectures . 1999; 48 629-643
8 Minas T. Treatment of chondral defects in the knee. Orthop Spec Ed . 1997; 3 69-74
9 Minas T, Nehrer S. Current concepts in the treatment of articular cartilage defects. Orthopedics . 1997; 20 525-538
10 Hangody L, Kish G, Karpati Z, Udvarhelyi I, Szigeti I, Bely M. Mosaicplasty for the treatment of articular cartilage defects: application in clinical practice. Orthopedics . 1998; 21 751-756
11 Minas T. A practical algorithm for cartilage repair. Op Tech Sports Med . 2000; 8 141-143
12 Recht M, Bobic V, Burstein D. Magnetic resonance imaging of articular cartilage. Clin Orthopaed Relat Res . 2001; 391 S379-S396
13 Potter H G, Linklater J M, Allen A A, Hannafin J A, Haas S B. Magnetic resonance imaging of articular cartilage in the knee. An evaluation with use of fast-spin-echo imaging. J Bone Joint Surg Am . 1998; 80 1276-1284
14 Recht M P, Piraino D W, Paletta G A, Schils J P, Belhobek G H. Accuracy of fat-suppressed three-dimensional spoiled gradient-echo FLASH MR imaging in the detection of patellofemoral articular cartilage abnormalities. Radiology . 1996; 198 209-212
15 Disler D G, McCauley T R, Kelman C G, Fuchs M D, Ratner L M, Wirth C R, Hospodar P P. Fat-suppressed three-dimensional spoiled gradient-echo MR imaging of hyaline cartilage defects in the knee: comparison with standard MR imaging and arthroscopy. Am J Roentgenol . 1996; 167 127-132
16 Winalski C S, Minas T. Evaluation of chondral injuries by magnetic resonance imaging: repair assessments. Op Tech Sports Med . 2000; 8 108-119
17 Steadman J R, Rodkey W G, Briggs K K, Rodrigo J J. The microfracture technique in the management of complete cartilage defects in the knee joint. Orthopade . 1999; 28 26-32
18 Passler H H. Microfracture for treatment of cartilage detects. Zentralbl Chir . 2000; 125 500-504
19 Buckwalter J A. Articular cartilage surfaces. Annual Meeting of the American Orthopaedic Society for Sports Medicine. Sun Valley, ID: June 2000
20 Steadman J R, Rodkey W G, Singleton S B, Briggs K K. Microfracture technique for full-thickness chondral defects: technique and clinical results. Op Tech Orthop . 1997; 7 300-304
21 Gilbert J E. Current treatment options for the restoration of articular cartilage. Am J Knee Surg . 1998; 11 42-46
22 Anderson L J. Chondral injuries. Current Issues of Magnetic Resonance Imaging in Orthopaedics and Sports Medicine: A National Symposium. San Francisco, CA: August 2000
23 Frisbie D D, Trotter G W, Powers B E. Arthroscopic subchondral bone plate microfracture technique augments healing of large chondral defects in the radial carpal bone and medial femoral condyle of horses. Vet Surg . 1999; 28 242-255
24 O'Driscoll S W. The healing and regeneration of articular cartilage. J Bone Joint Surg Am . 1998; 80 1795-1812
25 Sisto D J. The surgical treatment of full thickness osteochondral defects of the knee. Annual Meeting of the American Orthopaedic Society for Sports Medicine. Sun Valley, ID: June 2000
26 Mandelbaum B R. Articular cartilage repair: outcome and results. Annual Meeting of the American Orthopaedic Society for Sports Medicine. Sun Valley, ID: June 2000
27 Blevins F T, Steadman J R, Rodrigo J J, Silliman J. Treatment of articular cartilage defects in athletes: an analysis of functional outcome and lesion appearance. Orthopedics . 1998; 21 761-767
28 Sterett W I, Steadman J R. High tibial osteotomy and chondral resurfacing in the varus knee. Annual Meeting of the American Orthopaedic Society for Sports Medicine. Sun Valley, ID: June 2000
29 Frenkel S R, Di Cesare E P. Degradation and repair of articular cartilage. Front Biosci . 1999; 4 D671-D685
30 Bobic V. Arthroscopic osteochondral autograft transplantation in anterior cruciate ligament reconstruction: a preliminary clinical study. Knee Surg Sports Traumatol Arthrosc . 1996; 3 262-264
31 Matsusue Y, Yamamuro T, Hama H. Arthroscopic multiple osteochondral transplantation to the chondral defect in the knee associated with anterior cruciate ligament disruption. Arthroscopy . 1993; 9 318-321
32 Kish G, Modis L, Hangody L. Osteochondral mosaicplasty for the treatment of focal chondral and osteochondral lesions of the knee and talus in the athlete. Rationale, indications, techniques, and results. Clin Sports Med . 1999; 18 45-66
33 Hangody L, Kish G, Karpati Z, Szerb I, Eberhardt R. Treatment of osteochondritis dissecans of the talus: use of the mosaicplasty technique-a preliminary report. Foot Ankle Int . 1997; 18 628-634
34 Chen F S, Frenkel S R, Di Cesare E P. Repair of articular cartilage defects: part II. Treatment options. Am J Orthoped . 1999; 28 88-96
35 Farnworth L. Osteochondral defects of the knee. Orthopedics . 2000; 23 146-157
36 Yamashita F, Sakakida K, Suzu F, Takai S. The transplantation of an autogeneic osteochondral fragment for osteochondritis dissecans of the knee. Clin Orthop . 1985; 201 43-50
37 Outerbridge H K, Outerbridge A R, Outerbridge R E. The use of a lateral patellar autologous graft for the repair of a large osteochondral defect in the knee. J Bone Joint Surg Am . 1965; 77 65-72
38 Bradley J P. Osteochondral autograft transplantation clinical outcome study. Metcalf Memorial Meeting. Sun Valley, ID: 1999
39 Berlet G C, Mascia A, Miniaci A. Treatment of unstable osteochondritis dissecans lesions of the knee using autogenous osteochondral grafts (mosaicplasty). Arthroscopy . 1999; 15 312-316
40 Lane J M, Brighton C T, Ottens H R, Lipton M. Joint resurfacing in the rabbit using an autologous osteochondral graft. J Bone Joint Surg Am . 1977; 59 218-222
41 Dew T L, Martin R A. Functional, radiographic, and histologic assessment of healing of autogenous osteochondral grafts and full-thickness cartilage defects in the talus of dogs. Am J Vet Res . 1992; 53 2141-2152
42 Pearce S G, Hurtig M B, Clarnette R, Kalra M, Cowan B, Miniaci A. An investigation of 2 techniques for optimizing joint surface congruency using multiple cylindrical osteochondral autografts. Arthroscopy . 2001; 17 50-55
43 Duchow J, Hess T, Kohn D. Primary stability of press-fit-implanted osteochondral grafts. Influence of graft size, repeated insertion, and harvesting technique. Am J Sports Med . 2000; 28 24-27
44 Kattapuram S V, Rosol M S, Rosenthal D I, Palmer W E, Mankin H J. Magnetic resonance imaging features of allografts. Skeletal Radiol . 1999; 28 383-389
45 Kattapuram S V, Phillips W C, Mankin H J. Intercalary bone allografts: radiographic evaluation. Radiology . 1989; 170 137-141
46 Mankin H J, Fogelson F S, Thrasher A Z, Jaffer F. Massive resection and allograft transplantation in the treatment of malignant bone tumors. N Engl J Med . 1976; 294 1247-1255
47 Meyers M H. The surgical treatment of osteonecrosis of the femoral head with an osteochondral allograft. Acta Orthopaed Belg . 1999 (suppl 1); 65 (66-67)
48 Meyers M H, Jones R E, Bucholz R W, Wenger D R. Fresh autogenous grafts and osteochondral allografts for the treatment of segmental collapse in osteonecrosis of the hip. Clin Orthopaed Relat Res . 1983; 174 107-112
49 Meyers M H. Resurfacing of the femoral head with fresh osteochondral allografts. Long-term results. Clin Orthopaed Relat Res . 1985; 197 111-114
50 Gross A E, Agnidis Z, Hutchison C R. Osteochondral defects of the talus treated with fresh osteochondral allograft transplantation. Foot Ankle Int . 2001; 22 385-391
51 Beaver R J, Mahomed M, Backstein D, Davis A, Zukor D J, Gross A E. Fresh osteochondral allografts for post-traumatic defects in the knee. A survivorship analysis. J Bone Joint Surg Br . 1992; 74 105-110
52 Convery F R, Botte M J, Akeson W H, Meyers M H. Chondral defects of the knee. Contemp Orthopaed . 1994; 28 101-107
53 Mahomed M N, Beaver R J, Gross A E. The long-term success of fresh, small fragment osteochondral allografts used for intraarticular post-traumatic defects in the knee joint. Orthopedics . 1992; 15 1191-1199
54 Marco F, Lopez-Oliva F, Fernández-Fernández-Arroyo J M, de Pedro A J, Perez A J, Leon C, Lopez-Duran L. Osteochondral allografts for osteochondritis dissecans and osteonecrosis of the femoral condyles. Int Orthop . 1993; 17 104-108
55 Chu C R, Convery F R, Akeson W H, Meyers M, Amiel D. Articular cartilage transplantation. Clinical results in the knee. Clin Orthopaed Relat Res . 1999; 360 159-168
56 Meyers M H, Akeson W, Convery F R. Resurfacing of the knee with fresh osteochondral allograft. J Bone Joint Surg . 1989; 71 704-713
57 Ghazavi M T, Pritzker K P, Davis A M, Gross A E. Fresh osteochondral allografts for post-traumatic osteochondral defects of the knee. J Bone Joint Surg Br . 1997; 79 1008-1013
58 Bugbee W D, Jamali A, Chu C, Convery F R. Fresh osteochondral allografting of the patellofemoral joint. Annual Meeting of the American Academy of Orthopaedic Surgeons. San Francisco, CA: March 2001
59 Bugbee W D, Convery F R. Osteochondral allograft transplantation. Clin Sports Med . 1999; 18 67-75
60 Sirlin C B, Brossmann J, Boutin R D. Shell osteochondral allografts of the knee: comparison of MR imaging findings and immunologic responses. Radiology . 2001; 219 35-43
61 Kandel R A, Gross A E, Ganel A, McDermott A G, Langer F, Pritzker K P. Histopathology of failed osteoarticular shell allografts. Clin Orthop . 1985; 197 103-110
62 Pritzker K P, Gross A E, Langer F, Luk S C, Houpt J B. Articular cartilage transplantation. Hum Pathol . 1977; 8 635-651
63 Kusnick C, Hayward I, Sartoris D J, Haghighi P, Meyers M H, Akeson W, Resnick D. Radiographic evaluation of joints resurfaced with osteochondral shell allografts. Am J Roentgenol . 1987; 149 743-748
64 Rokkanen P U. Absorbable materials in orthopaedic surgery. Ann Med . 1991; 23 109-115
65 Friend G, Grace K, Stone H A. L-osteotomy with absorbable fixation for correction of tailor's bunion. J Foot Ankle Surg . 1993; 32 14-19
66 Atkinson P J, Lancaster R L, Atkinson T S, Arnoczky S P, Haut R C, Weisbrode S E. Breaking strength retention and histologic effects around 1.3-mm. ORTHOSORB polydioxanone absorbable pins at various sites in the rabbit. J Foot Ankle Surg . 1998; 37 42-47
67 Sirlin C B, Boutin R D, Brossmann J, Pathria M N, Convery F R, Bugbee W, Resnick D. Polydioxanone biodegradable pins in the knee: MR imaging. Am J Roentgenol . 2001; 176 83-90
68 Minas T. Autologous chondrocyte transplantation. Op Tech Sports Med . 2000; 8 144-157
69 Minas T, Peterson L. Advanced techniques in autologous chondrocyte transplantation. Clin Sports Med . 1999; 18 13-44
70 Breinan H A, Minas T, Hsu H P, Nehrer S, Sledge C B, Spector M. Effect of cultured autologous chondrocytes on repair of chondral defects in a canine model. J Bone Joint Surg Am . 1997; 79 1439-1451
71 Breinan H A, Minas T, Barone L. Histological evaluation of the course of healing of canine articular cartilage defects treated with cultured autologous chondrocytes. Tiss Eng . 1998; 4 101-114
72 Brittberg M, Lindahl A, Nilsson A, Ohlsson C, Isaksson O, Peterson L. Treatment of deep cartilage defects in the knee with autologous chondrocyte transplantation. N Engl J Med . 1994; 331 889-895
73 Peterson L, Minas T, Brittberg M, Nilsson A, Sjogren-Jansson E, Lindahl A. Two- to 9-year outcome after autologous chondrocyte transplantation of the knee. Clin Orthopaed Relat Res . 2000; 374 212-234
74 Minas T, Chiu R. Autologous chondrocyte implantation. Am J Knee Surg . 2000; 13 41-50
75 Mandelbaum B. Update on autologous chondrocyte implantation. ICRS Newsletter 1998 Spring:11
76 Alparslan L, Minas T, Winalski C S. Magnetic resonance imaging of autologous chondrocyte implantation. Semin Ultrasound CT MR . 2001; 22 341-351
77 Winalski C S, Stram E S, Chiu R I, Minas T. Diagnostic accuracy of MR for postoperative complications of autologous chondrocyte implantation. Radiology . 2000; 217P 450
78 Gillis A M, Bashir A, McKeon B. MRI evaluation of graft GAG content: does cartilage transplantation work?. Annual Meeting of the International Society for Magnetic Resonance in Medicine. Glasgow, Scotland: April 2001
79 Burkart A, Imhoff A B. Diagnostic imaging after autologous chondrocyte transplantation. Correlation of magnetic resonance tomography, histological and arthroscopic findings. Orthopade . 2000; 29 135-144
80 Winalski C S, Aliabadi P, Wright R J, Shortkroff S, Sledge C B, Weissman B N. Enhancement of joint fluid with intravenously administered gadopentetate dimeglumine: technique, rationale, and implications. Radiology . 1993; 187 179-185