Department of Orthopaedic Surgery and Traumatology, Ghent University Hospital, De Pintelaan 185, 1P5, B9000 Gent, Belgium.
Eur J Radiol. 2010 Jul;75(1):72-81. doi: 10.1016/j.ejrad.2009.03.056. Epub 2009 Apr 28.
The present study was designed to evaluate the implantation of alginate beads containing human mature allogenic chondrocytes for the treatment of symptomatic cartilage defects of the knee. MRI was used for the morphological analysis of cartilage repair. The correlation between MRI findings and clinical outcome was also studied.
A biodegradable, alginate-based biocompatible scaffold containing human mature allogenic chondrocytes was used for the treatment of symptomatic chondral and osteochondral lesions in the knee. Twenty-one patients were prospectively evaluated with use of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Visual Analogue Scale (VAS) for pain preoperatively and at 3, 6, 9 and 12 months of follow-up. Of the 21 patients, 12 had consented to follow the postoperative MRI evaluation protocol. MRI data were analyzed based on the original MOCART (Magnetic Resonance Observation of Cartilage Repair Tissue) and modified MOCART scoring system. The correlation between the clinical outcome and MRI findings was evaluated.
A statistically significant clinical improvement became apparent after 6 months and patients continued to improve during the 12 months of follow-up. One of the two MRI scoring systems that were used, showed a statistically significant deterioration of the repair tissue at 1 year of follow-up. Twelve months after the operation complete filling or hypertrophy was found in 41.6%. Bone-marrow edema and effusion were seen in 41.7% and 25% of the study patients, respectively. We did not find a consistent correlation between the MRI criteria and the clinical results.
The present study confirmed the primary role of MRI in the evaluation of cartilage repair. Two MOCART-based scoring systems were used in a longitudinal fashion and allowed a practical and morphological evaluation of the repair tissue. However, the correlation between clinical outcome and MRI findings was poor. Further validation of these scoring systems is mandatory. The promising short-term clinical outcome of the allogenic chondrocytes/alginate beads implantation was not confirmed by the short-term MRI findings.
本研究旨在评估含有人成熟同种异体软骨细胞的藻酸盐珠植入物治疗膝关节症状性软骨缺损的效果。采用 MRI 进行软骨修复的形态学分析，并研究 MRI 结果与临床结果的相关性。
采用一种可生物降解的、基于藻酸盐的生物相容性支架，其中含有成熟的人同种异体软骨细胞，用于治疗膝关节的症状性软骨和软骨下骨病变。21 例患者前瞻性地使用西安大略和麦克马斯特大学骨关节炎指数（WOMAC）和视觉模拟量表（VAS）进行术前及术后 3、6、9 和 12 个月的疼痛评估。21 例患者中有 12 例同意接受术后 MRI 评估方案。根据原始 MOCART（磁共振观察软骨修复组织）和改良 MOCART 评分系统分析 MRI 数据。评估临床结果与 MRI 结果的相关性。
术后 6 个月开始出现明显的临床改善，患者在 12 个月的随访中继续改善。使用的两种 MRI 评分系统中的一种，在 1 年随访时显示修复组织有统计学上的显著恶化。术后 12 个月，完全填充或肥大的患者比例为 41.6%。骨髓水肿和积液分别见于 41.7%和 25.0%的患者。我们没有发现 MRI 标准与临床结果之间存在一致的相关性。
本研究证实了 MRI 在软骨修复评估中的主要作用。两种基于 MOCART 的评分系统用于纵向评估，允许对修复组织进行实际和形态学评估。然而，临床结果与 MRI 结果之间的相关性较差。需要进一步验证这些评分系统。同种异体软骨细胞/藻酸盐珠植入的短期临床结果并不理想，这与短期 MRI 结果不一致。
