Abstract
BackgroundAssessment of degenerative changes of the cartilage is important in knee cartilage repair surgery. Magnetic Resonance Imaging (MRI) T2 mapping and delayed Gadolinium Enhanced MRI of Cartilage (dGEMRIC) are able to detect early degenerative changes. The hypothesis of the study was that cartilage surrounding a focal cartilage lesion in the knee does not possess degenerative changes.MethodsTwenty-eight consecutive patients included in a randomized controlled trial on cartilage repair were evaluated using MRI T2 mapping and dGEMRIC before cartilage treatment was initiated. Inclusion was based on disabling knee problems (Lysholm score of ≤ 75) due to an arthroscopically verified focal femoral condyle cartilage lesion. Furthermore, no major malalignments or knee ligament injuries were accepted. Mean patient age was 33 ± 9.6 years, and the mean duration of knee symptoms was 49 ± 60 months. The MRI T2 mapping and the dGEMRIC measurements were performed at three standardized regions of interest (ROIs) at the medial and lateral femoral condyle, avoiding the cartilage lesionResultsThe MRI T2 mapping of the cartilage did not demonstrate significant differences between condyles with or without cartilage lesions. The dGEMRIC results did not show significantly lower values of the affected condyle compared with the opposite condyle and the contra-lateral knee in any of the ROIs. The intraclass correlation coefficient (ICC) of the dGEMRIC readings was 0.882.ConclusionThe MRI T2 mapping and the dGEMRIC confirmed the arthroscopic findings that normal articular cartilage surrounded the cartilage lesion, reflecting normal variation in articular cartilage quality.Study identifierNCT00885729, registered April 17 2009.Electronic supplementary materialThe online version of this article (doi:10.1186/s12891-016-0941-y) contains supplementary material, which is available to authorized users.
Highlights
Assessment of degenerative changes of the cartilage is important in knee cartilage repair surgery
Patients included in a randomized controlled trial (RCT) on cartilage repair were subjected to evaluation by Magnetic Resonance Imaging (MRI) T2 mapping and a delayed Gadolinium Enhanced MRI of Cartilage (dGEMRIC) to test the study hypothesis prior to treatment. 72 (22 %) of 332 eligible patients were included in the original RCT
The aim of the current study was to reveal whether a difference greater than the level of interest (100 ms) in the dGEMRIC readings could be found between the injured cartilage and the normal condyle in both injured and contralateral knees
Summary
Assessment of degenerative changes of the cartilage is important in knee cartilage repair surgery. Magnetic Resonance Imaging (MRI) T2 mapping and delayed Gadolinium Enhanced MRI of Cartilage (dGEMRIC) are able to detect early degenerative changes. To assess changes in cartilage before surgery, Magnetic Resonance Imaging (MRI) is the established method of choice in addition to arthroscopic evaluation. Årøen et al BMC Musculoskeletal Disorders (2016) 17:73 early degenerative changes in the surrounding cartilage without substance loss are difficult to assess; for example, chondrocyte harvesting from the edge of the lesion revealed inferior results to the more standard biopsy [6]. MRI T2 mapping and the delayed Gadolinium Enhanced MRI of Cartilage (dGEMRIC) have been used in trials to assess cartilage quality before joint preserving surgery [7] and in the follow-up of repair procedures [8]. Though MRI T2 mapping is capable of assessing collagen organization [9], the dGEMRIC technique can indirectly reflect the proteoglycan concentration [10, 11]
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