Koller Ulrich, Springer Bernhard, Rentenberger Colleen, Szomolanyi Pavol, Waldstein Wenzel, Windhager Reinhard, Trattnig Siegfried, Apprich Sebastian
Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
High-Field MR Centre, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Gürtel 18-20, 1090 Vienna, Austria.
J Clin Med. 2020 Apr 22;9(4):1202. doi: 10.3390/jcm9041202.
The effect of radiofrequency chondroplasty on cartilage tissue is not well studied. This prospective pilot study investigates the effect of radiofrequency chondroplasty on International Cartilage Repair Society (ICRS) grade II patellar cartilage defects using high-resolution magnetic resonance imaging (MRI) with T2 mapping. Six consecutive patients were treated for ICRS grade II patellar cartilage defects using radiofrequency chondroplasty. Before surgery and at defined follow-ups (2 weeks, 4 and 12 months) a high-resolution morphological 3 Tesla MRI with quantitative T2 mapping was performed. At baseline MRI, global T2 values of cartilage defects were increased (46.8 ms ± 9.7) compared to healthy cartilage (35.2 ms ± 4.5) in the same knee which served as reference. Two weeks after treatment, global T2 values (39.2 ms ± 7.7) of the defect areas decreased. However, global T2 values of the defect areas increased beyond the preoperative levels at 4 months (47.4 ms ± 3.1) and 12 months (51.5 ms ± 5.9), respectively. Zonal T2 mapping revealed that the predominant changes in T2 values occurred at the superficial cartilage layer. T2 mapping appears to be an ideal method to monitor cartilage degeneration after chondroplasty. Based on the small sample size of this pilot study, radiofrequency chondroplasty may cause cartilage damage and may not have a long-lasting effect in the treatment of grade II patellar cartilage defects. In five out of six patients, postoperative cartilage damage was observed on quantitative MRI. This study was therefore terminated before completion. We recommend only addressing the pathology which indicated arthroscopy and leaving concomitant cartilage lesions untreated.
射频软骨成形术对软骨组织的影响尚未得到充分研究。这项前瞻性初步研究使用具有T2映射的高分辨率磁共振成像（MRI），研究射频软骨成形术对国际软骨修复协会（ICRS）II级髌软骨缺损的影响。连续6例患者接受了射频软骨成形术治疗ICRS II级髌软骨缺损。在手术前以及确定的随访期（2周、4个月和12个月）进行了具有定量T2映射的高分辨率形态学3特斯拉MRI检查。在基线MRI检查时，与同一膝关节中作为参照的健康软骨（35.2 ms±4.5）相比，软骨缺损的整体T2值升高（46.8 ms±9.7）。治疗后2周，缺损区域的整体T2值（39.2 ms±7.7）下降。然而，缺损区域的整体T2值在4个月（47.4 ms±3.1）和12个月（51.5 ms±5.9）时分别升高至术前水平以上。区域T2映射显示，T2值的主要变化发生在软骨表层。T2映射似乎是监测软骨成形术后软骨退变的理想方法。基于这项初步研究的小样本量，射频软骨成形术可能会导致软骨损伤，并且在治疗II级髌软骨缺损时可能没有持久的效果。在6例患者中的5例中，定量MRI观察到术后软骨损伤。因此，这项研究在完成前终止。我们建议仅处理提示关节镜检查的病理情况，而不治疗伴发的软骨损伤。
