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Poor outcome after a surgically treated chondral injury on the medial femoral condyle : early evaluation with dGEMRIC and 17-year radiographic and clinical follow-up in 16 knees

Tjörnstrand, Jon LU ; Neuman, Paul LU ; Lundin, Björn LU ; Svensson, Jonas LU ; Dahlberg, Leif E. LU and Tiderius, Carl Johan LU (2018) In Acta Orthopaedica 89(4). p.431-436
Abstract

Background and purpose — The optimal treatment for traumatic cartilage injuries remains unknown. Contrast-enhanced MRI of cartilage (dGEMRIC) evaluates cartilage quality and a low dGEMRIC index may predict radiographic osteoarthritis (OA). The purpose of this study was (a) to explore the results 17 years after surgical treatment of an isolated cartilage knee injury and (b) to evaluate the predictive value of dGEMRIC. Patients and methods — 16 knees with an isolated traumatic cartilage injury of the medial femoral condyle had cartilage repair surgery either by microfracture or autologous cartilage implantation. dGEMRIC of the injured knee was performed 2 years after surgery and radiographic examinations were performed 17 years after the... (More)

Background and purpose — The optimal treatment for traumatic cartilage injuries remains unknown. Contrast-enhanced MRI of cartilage (dGEMRIC) evaluates cartilage quality and a low dGEMRIC index may predict radiographic osteoarthritis (OA). The purpose of this study was (a) to explore the results 17 years after surgical treatment of an isolated cartilage knee injury and (b) to evaluate the predictive value of dGEMRIC. Patients and methods — 16 knees with an isolated traumatic cartilage injury of the medial femoral condyle had cartilage repair surgery either by microfracture or autologous cartilage implantation. dGEMRIC of the injured knee was performed 2 years after surgery and radiographic examinations were performed 17 years after the operation. Results — Radiographic OA was present in 12 of 16 knees. Irrespective of surgical method, the dGEMRIC index was lower in repair tissue compared with adjacent cartilage in the medial compartment, 237 ms vs. 312 ms (p < 0.001), which in turn had lower value than in the non-injured lateral cartilage, 312 ms vs. 354 ms (p < 0.008). The dGEMRIC index in the cartilage adjacent to the repair tissue correlated negatively with radiographic osteophyte score, r = –0.75 (p = 0.03). Interpretation — A traumatic cartilage injury is associated with a high prevalence of OA after 17 years. The low dGEMRIC index in the repair tissue 2 years postoperatively indicates fibrocartilage of low quality. The negative correlation between the dGEMRIC index in the adjacent cartilage and future OA suggests that the quality of the surrounding cartilage influences outcome after cartilage repair surgery.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta Orthopaedica
volume
89
issue
4
pages
431 - 436
publisher
Taylor & Francis
external identifiers
  • scopus:85048060905
ISSN
1745-3674
DOI
10.1080/17453674.2018.1481304
language
English
LU publication?
yes
id
d05feb21-dc4b-4e8a-9e64-8e3dbb07d650
date added to LUP
2018-06-19 12:49:14
date last changed
2019-01-14 15:56:46
@article{d05feb21-dc4b-4e8a-9e64-8e3dbb07d650,
  abstract     = {<p>Background and purpose — The optimal treatment for traumatic cartilage injuries remains unknown. Contrast-enhanced MRI of cartilage (dGEMRIC) evaluates cartilage quality and a low dGEMRIC index may predict radiographic osteoarthritis (OA). The purpose of this study was (a) to explore the results 17 years after surgical treatment of an isolated cartilage knee injury and (b) to evaluate the predictive value of dGEMRIC. Patients and methods — 16 knees with an isolated traumatic cartilage injury of the medial femoral condyle had cartilage repair surgery either by microfracture or autologous cartilage implantation. dGEMRIC of the injured knee was performed 2 years after surgery and radiographic examinations were performed 17 years after the operation. Results — Radiographic OA was present in 12 of 16 knees. Irrespective of surgical method, the dGEMRIC index was lower in repair tissue compared with adjacent cartilage in the medial compartment, 237 ms vs. 312 ms (p &lt; 0.001), which in turn had lower value than in the non-injured lateral cartilage, 312 ms vs. 354 ms (p &lt; 0.008). The dGEMRIC index in the cartilage adjacent to the repair tissue correlated negatively with radiographic osteophyte score, r = –0.75 (p = 0.03). Interpretation — A traumatic cartilage injury is associated with a high prevalence of OA after 17 years. The low dGEMRIC index in the repair tissue 2 years postoperatively indicates fibrocartilage of low quality. The negative correlation between the dGEMRIC index in the adjacent cartilage and future OA suggests that the quality of the surrounding cartilage influences outcome after cartilage repair surgery.</p>},
  author       = {Tjörnstrand, Jon and Neuman, Paul and Lundin, Björn and Svensson, Jonas and Dahlberg, Leif E. and Tiderius, Carl Johan},
  issn         = {1745-3674},
  language     = {eng},
  month        = {06},
  number       = {4},
  pages        = {431--436},
  publisher    = {Taylor & Francis},
  series       = {Acta Orthopaedica},
  title        = {Poor outcome after a surgically treated chondral injury on the medial femoral condyle : early evaluation with dGEMRIC and 17-year radiographic and clinical follow-up in 16 knees},
  url          = {http://dx.doi.org/10.1080/17453674.2018.1481304},
  volume       = {89},
  year         = {2018},
}