Department of Radiology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.
Department of Orthopaedic Sports Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany; Department of Trauma and Orthopaedic Surgery, BG Unfallklinik Murnau, Murnau, Germany.
Osteoarthritis Cartilage. 2019 Jan;27(1):90-98. doi: 10.1016/j.joca.2018.08.023. Epub 2018 Sep 22.
To investigate whether T2 relaxation time measurements of cartilage repair tissue and structural changes of the knee joint are associated with subchondral bone architecture after spongiosa-augmented matrix-associated autologous chondrocyte implantation (MACI).
Both knees of 25 patients (25.5 ± 7.8y; 10 women) were examined preoperatively and 2.7 years after unilateral spongiosa-augmented MACI with 3T magnetic resonance (MR) imaging. Cartilage composition was assessed using T2 relaxation time measurements, subchondral trabecular bone microstructure was quantified using a 3D phase-cycled balanced steady state free-precision sequence. Structural knee joint changes were assessed using the modified Whole-Organ Magnetic Resonance Imaging Score (WORMS). The Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score was used for the postoperative description of the area that underwent MACI. Correlations were assessed using Spearman's rank correlation coefficients.
Hypertrophy of the cartilage repair tissue was found in 2 of 25 patients, both after a MACI procedure at the patella, 21 patients showed congruent filling. In subchondral bone of the cartilage repair compartment, apparent trabecular thickness was significantly higher in compartments with elevated cartilage T2 (n = 17; 0.37 ± 0.05 mm) compared to those showing no difference in cartilage T2 compared to the same compartment in the contralateral knee (n = 8; 0.27 ± 0.05 mm; P = 0.042). Significant correlations were found between the overall progression of WORMS and the ipsilateral vs contralateral ratio of average trabecular thickness (r = 0.48, P = 0.031) and bone fraction (r = 0.57, P = 0.007).
After spongiosa-augmented MACI, T2 values of cartilage repair tissue and structural knee joint changes correlated with the quality of the underlying trabecular bone.
研究软骨修复组织的 T2 弛豫时间测量值和膝关节结构变化与骨海绵增强基质相关自体软骨细胞植入 (MACI) 后软骨下骨结构之间的关系。
对 25 名患者（25.5±7.8 岁；10 名女性）的双侧膝关节进行术前和单侧骨海绵增强 MACI 后 2.7 年的 3T 磁共振 (MR) 成像检查。使用 T2 弛豫时间测量值评估软骨成分，使用 3D 相位循环平衡稳态自由精准序列定量评估软骨下小梁骨微观结构。使用改良的全器官磁共振成像评分 (WORMS) 评估结构膝关节变化。MOCART 评分用于描述接受 MACI 手术的区域的术后情况。使用 Spearman 秩相关系数评估相关性。
25 名患者中有 2 名患者（均为髌骨 MACI 术后）出现软骨修复组织的肥大，21 名患者显示出一致的填充。在软骨修复区的软骨下骨中，与同一膝关节对侧相比，T2 升高的软骨修复区的明显骨小梁厚度明显更高（n=17；0.37±0.05mm）（n=8；0.27±0.05mm；P=0.042）。WORMS 总体进展与同侧与对侧平均骨小梁厚度比值（r=0.48，P=0.031）和骨分数比值（r=0.57，P=0.007）之间存在显著相关性。
在骨海绵增强 MACI 后，软骨修复组织的 T2 值和膝关节结构变化与潜在小梁骨的质量相关。
