Department of Physics and Mathematics, University of Eastern Finland, Kuopio Campus, Kuopio, Finland.
Department of Physics and Mathematics, University of Eastern Finland, Kuopio Campus, Kuopio, Finland ; Department of Diagnostic Radiology, University of Oulu, Oulu, Finland.
Cartilage. 2011 Jul;2(3):246-53. doi: 10.1177/1947603510391781.
We tested whether an intra-articular ultrasound (IAUS) method could be used to evaluate cartilage status arthroscopically in human knee joints in vivo.
Seven patients undergoing arthroscopic surgery of the knee were enrolled in this study. An ultrasonic examination was conducted using the same portals as in the arthroscopic surgery. A high-frequency (40-MHz) ultrasound transducer (diameter = 1 mm) was directed to the desired location on the articular surface under arthroscopic control. In addition to ultrasound data, an IAUS video and optical video through the arthroscope were recorded. Classification of cartilage injuries according to International Cartilage Repair Society, as conducted by the orthopedic surgeon, provided reference data for comparison with the IAUS.
The IAUS method was successful in imaging different characteristics of the articular surfaces (e.g., intact surface, surface fibrillation, and lesions of varying depth). In some cases, also the subchondral bone and abnormal internal cartilage structure were visible in the IAUS images. Specifically, using the IAUS, a local cartilage lesion of 1 patient was found to be deeper than estimated arthroscopically.
The IAUS method provided a novel arthroscopic method for quantitative imaging of articular cartilage lesions. The IAUS provided quantitative information about the cartilage integrity and thickness, which are not available in conventional arthroscopy. The present equipment is already approved by the Food and Drug Administration for intravascular use and might be transferred to intra-articular use. The invasiveness of the IAUS method might restrict its wider clinical use but combined with arthroscopy, ultrasonic assessment may enlarge the diagnostic potential of arthroscopic surgery.
本研究旨在检验关节内超声（IAUS）方法能否用于活体人膝关节关节镜下评估软骨状态。
本研究纳入 7 例行膝关节关节镜手术的患者。在关节镜手术相同入路进行超声检查。在关节镜控制下，将高频（40MHz）超声换能器（直径=1mm）引导至关节表面的预期位置。除了超声数据外，还记录了 IAUS 视频和通过关节镜的光学视频。由骨科医生进行的根据国际软骨修复学会的软骨损伤分类为与 IAUS 进行比较提供了参考数据。
IAUS 方法成功地对关节表面的不同特征进行成像（例如，完整表面、表面纤维化和不同深度的病变）。在某些情况下，IAUS 图像中还可以看到软骨下骨和异常的内部软骨结构。具体来说，使用 IAUS，发现 1 例患者的局部软骨病变比关节镜下估计的要深。
IAUS 方法为关节软骨病变的定量成像提供了一种新的关节镜方法。IAUS 提供了有关软骨完整性和厚度的定量信息，这在常规关节镜下无法获得。目前的设备已经获得美国食品和药物管理局批准用于血管内使用，并且可能被转移到关节内使用。IAUS 方法的侵入性可能会限制其更广泛的临床应用，但与关节镜结合使用，超声评估可能会扩大关节镜手术的诊断潜力。
