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用于评估软骨修复的MOCART和MOCART 2.0的相关性及比较评价

Correlation and Comparative Evaluation of MOCART and MOCART 2.0 for Assessing Cartilage Repair.

作者信息

Oettl Felix Conrad, Leuthard Louis, Brunner Moritz, Stadelmann Vincent A, Preiss Stefan, Leunig Michael, Salzmann Gian M, Hax Jakob

机构信息

Department of Hip and Knee Surgery, Schulthess Klinik, 8008 Zurich, Switzerland.

Hospital for Special Surgery, New York, NY 10021, USA.

出版信息

Medicina (Kaunas). 2025 Apr 18;61(4):745. doi: 10.3390/medicina61040745.

Abstract

: Chondral and osteochondral lesions can lead to osteoarthritis if untreated, making accurate assessment of cartilage repair outcomes essential for optimizing treatment strategies. The objective of this study was to compare MOCART and MOCART 2.0 and to evaluate the clinical utility of both across different surgical cartilage repair techniques and various time points. : This study included 111 patients (age: 35 ± 10, 35% female) who underwent cartilage repair surgery of the knee between September 2015 and March 2022. A total of 188 postoperative magnetic resonance images were evaluated using MOCART and MOCART 2.0. The correlations between both scores, as well as to the change in Patient-Reported Outcome Measures (PROMs), were determined. : MOCART 2.0 scores (66 ± 13) were significantly higher than MOCART scores (58 ± 13, < 0.001). Positive correlation was observed between scoring systems (r = 0.837, < 0.001). There was no significant correlation between MOCART or MOCART 2.0 scores and the change in PROMs. Noticeably, there was a statistically significant correlation between both MOCART and MOCART 2.0 in the AutoCart subgroup across multiple timepoints for the change in PROMs. : Based on radiographic-clinical outcome discordance, clinicians should not rely solely on MOCART or MOCART 2.0 scores when evaluating cartilage repair success but instead prioritize patient-reported functional improvements while using imaging as a complementary assessment tool.

摘要

软骨和骨软骨损伤若不治疗可导致骨关节炎,因此准确评估软骨修复结果对于优化治疗策略至关重要。本研究的目的是比较MOCART和MOCART 2.0,并评估两者在不同手术软骨修复技术和不同时间点的临床实用性。

本研究纳入了111例在2015年9月至2022年3月期间接受膝关节软骨修复手术的患者(年龄:35±10岁,35%为女性)。共使用MOCART和MOCART 2.0对188张术后磁共振图像进行了评估。确定了两个评分之间的相关性,以及与患者报告的结局指标(PROMs)变化之间的相关性。

MOCART 2.0评分(66±13)显著高于MOCART评分(58±13,<0.001)。评分系统之间存在正相关(r = 0.837,<0.001)。MOCART或MOCART 2.0评分与PROMs变化之间无显著相关性。值得注意的是,在AutoCart亚组中,MOCART和MOCART 2.0在多个时间点对于PROMs变化均存在统计学显著相关性。

基于影像学 - 临床结果不一致性,临床医生在评估软骨修复成功与否时不应仅依赖MOCART或MOCART 2.0评分,而应在将影像学作为补充评估工具的同时,优先考虑患者报告的功能改善情况。

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