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膝关节软骨修复的磁共振成像表现

Magnetic resonance imaging appearance of cartilage repair in the knee.

作者信息

Brown Wendy E, Potter Hollis G, Marx Robert G, Wickiewicz Thomas L, Warren Russell F

机构信息

Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY 10021, USA.

出版信息

Clin Orthop Relat Res. 2004 May(422):214-23. doi: 10.1097/01.blo.0000129162.36302.4f.

Abstract

Assessment of surgically repaired cartilage lesions with standardized cartilage sensitive magnetic resonance imaging was done to evaluate the integrity, morphologic features, and signal of the articular surface, thereby obtaining information about the natural history of these procedures in the knee. Magnetic resonance imaging also assessed the interface between the repaired and native cartilage, changes in the subchondral bone, and the appearance of cartilage over the opposite and adjacent (native) surfaces. One hundred eighty magnetic resonance imaging examinations were obtained in 112 patients who had cartilage-resurfacing procedures, including 86 microfractures and 35 autologous chondrocyte implantations, at a mean of 15 and 13 months after surgery, respectively. Autologous chondrocyte implantations showed consistently better fill of the defects at all times compared with microfracture. The graft hypertrophied in 63% of surgeries. The repair cartilage over the microfracture generally was depressed with respect to native cartilage. Propensity for bony overgrowth was most marked in the microfracture group, with loss of adjacent cartilage evident with progressive followup.

摘要

采用标准化的软骨敏感磁共振成像对手术修复的软骨损伤进行评估,以评价关节面的完整性、形态特征和信号,从而获取有关膝关节这些手术自然病程的信息。磁共振成像还评估了修复软骨与天然软骨之间的界面、软骨下骨的变化以及相对和相邻(天然)表面软骨的外观。对112例行软骨表面修复手术的患者进行了180次磁共振成像检查,其中包括86例微骨折手术和35例自体软骨细胞移植手术,分别在术后平均15个月和13个月进行检查。与微骨折相比,自体软骨细胞移植在所有时间点缺损填充情况始终更好。63%的手术中移植物出现肥大。微骨折处的修复软骨相对于天然软骨通常呈凹陷状。骨过度生长倾向在微骨折组最为明显,随着随访进展,相邻软骨明显缺失。

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