Department of Trauma Surgery, Medical University of Vienna, Vienna, Austria,
Knee Surg Sports Traumatol Arthrosc. 2014 Jun;22(6):1288-97. doi: 10.1007/s00167-014-2834-7. Epub 2014 Jan 23.
Autologous osteochondral transplantation (OCT) is one of the surgical options currently used to treat cartilage defects. It is the only cartilage repair method that leads to a transfer of hyaline cartilage repair tissue. The purpose of this study was to evaluate the magnetic resonance observation of cartilage repair tissue (MOCART) score, the 3D MOCART score and various clinical scores in patients after OCT in knee joints.
Two women and eight men were evaluated 6-9 years (median 7.2 years) after OCT on the femoral condyle of the knee joint. All patients were evaluated by magnetic resonance imaging (MRI) measurement, using a 3.0 T Scanner with different cartilage-specific sequences. Clinical assessment included the knee injury and osteoarthritis outcome score (KOOS), the international knee documentation committee (IKDC) subjective knee form, the Noyes sport activity rating scale and the Tegner activity score. For MRI evaluation, the MOCART score and 3D MOCART score were applied.
Clinical long-term results after OCT showed median values of 77 (range 35.7-71.4) for the IKDC; 50 (6.3-100), 66.7 (30.6-97.2), 65 (0-75), 57.1 (35.7-71.4) and 80.9 (30.9-100) for the KOOS subscales (quality of life, pain sports, symptoms and activity of daily living); 61.4 (22.3-86.2) for the Noyes scale; and 3 (0-6) for the Tegner activity score. The median MOCART score was 75 (30-90) after both 1 and 2 years and 57.5 (35-90) after 7 years, as assessed by different cartilage-specific sequences. The 3D MOCART score showed values of 70 (50-85) and 60 (50-80) in the two different isotropic sequences after 7 years.
The MOCART and 3D MOCART scores are applicable tools for patient follow-up after OCT. Post-operative follow-up assessments would also benefit from the inclusion of OCT-specific parameters. Long-term results after OCT reflect an impairment in clinical scores in the first 2 years with good results during follow-up. Stable conditions were observed between 2 and 7 years after surgery. The filling of the defects and the cartilage interface appeared good at MRI evaluation after the first 2 years, but cartilage loss was observed between the medium- and long-term follow-ups. Isotropic imaging with multiplanar reconstruction is useful for daily clinical use to assess bony cylinders in cartilage repair, especially in combination with the 3D MOCART.
Retrospective therapeutic study, Level IV.
自体软骨移植（OCT）是目前用于治疗软骨缺损的手术选择之一。它是唯一能导致透明软骨修复组织转移的软骨修复方法。本研究旨在评估膝关节 OCT 后患者的磁共振软骨修复组织观察评分（MOCART）、3D-MOCART 评分和各种临床评分。
两名女性和八名男性在 OCT 后 6-9 年（中位数 7.2 年）对膝关节股骨髁进行评估。所有患者均采用不同的软骨特异性序列在 3.0T 扫描仪上进行磁共振成像（MRI）测量。临床评估包括膝关节损伤和骨关节炎评分（KOOS）、国际膝关节文献委员会（IKDC）主观膝关节评分、Noyes 运动活动评分和 Tegner 活动评分。对于 MRI 评估，应用了 MOCART 评分和 3D-MOCART 评分。
OCT 后膝关节的长期临床结果显示，IKDC 的中位数为 77（范围 35.7-71.4）；50（6.3-100）、66.7（30.6-97.2）、65（0-75）、57.1（35.7-71.4）和 80.9（30.9-100）为 KOOS 亚组（生活质量、疼痛运动、症状和日常生活活动）；Noyes 量表为 61.4（22.3-86.2）；Tegner 活动评分为 3（0-6）。不同软骨特异性序列评估后，MOCART 评分在 1 年和 2 年均为 75（30-90），7 年时为 57.5（35-90）。3D-MOCART 评分在 7 年后的两个不同各向同性序列中分别为 70（50-85）和 60（50-80）。
MOCART 和 3D-MOCART 评分是 OCT 后患者随访的适用工具。术后随访评估还将受益于 OCT 特定参数的纳入。OCT 后 2 年内的临床评分出现损害，随后的随访结果良好。术后 2 年至 7 年之间观察到稳定的情况。在最初的 2 年中，MRI 评估显示缺损的填充和软骨界面良好，但在中、长期随访中观察到软骨丢失。具有多平面重建的各向同性成像对于日常临床使用评估软骨修复中的骨圆柱很有用，特别是与 3D-MOCART 结合使用时。
回顾性治疗研究，IV 级。
