Department of Radiology, Università Degli Studi del Piemonte Orientale, Alessandria, Italy.
Department of Orthopedics and Rehabilitation, Università Degli Studi del Piemonte Orientale, Alessandria, Italy.
Radiol Med. 2023 Nov;128(11):1415-1422. doi: 10.1007/s11547-023-01716-4. Epub 2023 Oct 3.
Patellar femoral chondropathy (FPC) is a common problem in patients undergoing anterior cruciate ligament reconstruction (ACL-R) surgery, which, if left untreated, predisposes to arthrosis. Magnetic resonance imaging (MRI) is the non-invasive gold standard for morphological evaluation of cartilage, while in recent years advanced MRI techniques (such as T2 mapping) have been developed to detect early cartilage biochemical changes. This study evaluates the different onset of early PFC between B-TP-B and HT through T2 mapping. Secondly, it aims to assess the presence of any concordance between self-reported questionnaires and qualitative MRI.
19 patients enrolled were divided into two groups based on the type of intervention: B-PT-B and HT. After a median time of 54 months from surgery, patients were subjected to conventional MRI, T2 mapping, and clinical-functional evaluation through three self-reported questionnaires: Knee Injury and Osteoarthritis index (KOOS); Tegner Lysholm Knee Scoring Scale; International Knee Documentation Committee (IKDC).
There is not statistically significant difference in the comparison between the two MRI techniques and the two reconstructive techniques. KOOS and Tegner Lysholm scales showed significant agreement with MRI results on the grading of chondropathy.
There are no differences between B-TP-B and HT techniques in the early development of PFC detectable through non-invasive methods. Due to the large reduction in the frequency of physical activity following ACL-R and the finding of mild PFC (grade I and II) in a substantial proportion of patients, after a relatively short period from ACL-R, all patients should undergo conservative treatment.
髌股软骨病(FPC)是前交叉韧带重建(ACL-R)术后患者常见的问题,如果不进行治疗,会导致关节炎。磁共振成像(MRI)是评估软骨形态的非侵入性金标准,而近年来已经开发出了先进的 MRI 技术(如 T2 映射)来检测早期软骨生化变化。本研究通过 T2 映射评估 B-TP-B 和 HT 之间早期 PFC 的不同发病情况。其次,旨在评估自我报告问卷和定性 MRI 之间是否存在任何一致性。
19 名入组患者根据干预类型分为两组:B-PT-B 和 HT。手术 54 个月后,患者接受了常规 MRI、T2 映射和通过三个自我报告问卷的临床功能评估:膝关节损伤和骨关节炎指数(KOOS);Tegner Lysholm 膝关节评分量表;国际膝关节文献委员会(IKDC)。
两种 MRI 技术和两种重建技术之间的比较没有统计学意义。KOOS 和 Tegner Lysholm 量表在软骨病分级的 MRI 结果上显示出显著的一致性。
通过非侵入性方法,B-TP-B 和 HT 技术在早期 PFC 的发展方面没有差异。由于 ACL-R 后体力活动的频率大幅减少,以及相当一部分患者出现轻度 PFC(I 级和 II 级),因此在 ACL-R 后相对较短的时间内,所有患者都应接受保守治疗。