CT arthrography visualizes tissue growth of osteochondral defects of the talus after microfracture

Jung, Hong-Geun; Kim, Nara; Jeon, Ji-Young; Lee, Dong‐Oh; Eom, Jun-Sang; Lee, Jong-Soo; Kim, Sung-Wook

doi:10.1007/s00167-017-4610-y

Cited by 12 publications

(12 citation statements)

References 31 publications

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“…Direct MR arthrography has classically been considered the method of choice for assessing internal joint derangement and cartilage integrity [21,22]. On the other hand, CT arthrography offers an alternative to MR arthrography, capable of isotropic data acquisition with high spatial resolution, and may routinely be used for cartilage imaging [6,7,12]. Recently, an innovative CT scanner design providing volumetric imaging with ultra-high spatial resolution consists in the use of digital flat-panel detectors [23].…”

Section: Discussionmentioning

confidence: 99%

“…Current detector designs in multidetector CT (MDCT) can reach a maximal z-resolution of 0.4-0.5 mm, enabling the detection of small cartilage and bone lesions that could be overlooked in MR arthrography [10,11]. Thus, MDCT arthrography is considered the method of choice in the assessment of articular cartilage, especially in the ankle joint where hyaline cartilage is particularly thin [3,6,7,12].…”

Section: Introductionmentioning

confidence: 99%

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Flat-panel CT arthrography for cartilage defect detection in the ankle joint: first results in vivo

et al. 2020

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Objectives The purpose of this study was to compare the diagnostic performance of flat-panel computed tomography (FPCT) arthrography for cartilage defect detection in the ankle joint to direct magnetic resonance (MR) arthrography using multidetector computed tomography (MDCT) arthrography as the reference standard. Methods Twenty-seven patients with specific suspicion of articular cartilage lesion underwent ankle arthrography with injection of a mixture of diluted gadolinium and iobitridol and were examined consecutively with the use of FPCT, MDCT, and 1.5 T MR imaging. FPCT, MDCT, and MR arthrography examinations were blinded and randomly evaluated by two musculoskeletal radiologists in consensus. In each ankle, eight articular cartilage areas were assessed separately: medial talar surface, medial talar trochlea, lateral talar trochlea, lateral talar surface, tibial malleolus, medial tibial plafond, lateral tibial plafond, and fibular malleolus. Findings at FPCT and MR were compared with MDCT assessments in 216 cartilage areas. Results For the detection of cartilage defects, FPCT demonstrated a sensitivity of 97%, specificity of 95%, and accuracy of 96%; and MR arthrography showed a sensitivity of 69%, specificity of 94%, and accuracy of 87%. FPCT and MR arthrography presented almost perfect agreement (κ = 0.87) and moderate agreement (κ = 0.60), respectively, with MDCT arthrography. Mean diagnostic confidence was higher for FPCT (2.9/3) than for MR (2.3/3) and MDCT (2.7/3) arthrography. Conclusions FPCT demonstrated better accuracy than did 1.5 T MR arthrography for cartilage defect detection in the ankle joint. Therefore, FPCT should be considered in patients scheduled for dedicated imaging of ankle articular cartilage.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Flat-panel CT arthrography for cartilage defect detection in the ankle joint: first results in vivo

et al. 2020

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“…The most definite method of evaluating postoperative articular changes is second-look ankle arthroscopy, but second-look ankle arthroscopy should be strictly limited to situations where chronic significant pain persists postoperatively and that additional arthroscopic evaluations or treatments are necessary. Therefore, ankle MRI or CT arthrography has been utilized as a viable imaging modality to evaluate the postoperative ankle articular cartilage status [6].…”

Section: Discussionmentioning

confidence: 99%

“…For the correct diagnosis of early medial ankle OA in patients with CAI with high sensitivity, we utilized the localized medial ankle pain symptoms, as well as radiographic joint space narrowing, osteophyte formation, cartilage denudation on the MR images, and, most importantly, degenerative ankle arthroscopic cartilage findings. Furthermore, ankle MRI or ankle CT arthrography was found to be an effective imaging diagnostic tool for postoperative ankle articular cartilage evaluations [6].…”

Section: Discussionmentioning

confidence: 99%

Ligament stabilization improved clinical and radiographic outcomes for individuals with chronic ankle instability and medial ankle osteoarthritis

Kim

Jung

Lee

2020

Knee Surg Sports Traumatol Arthrosc

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Purpose Chronic ankle instability with a long symptom duration is often accompanied by medial compartment ankle osteoarthritis (OA). However, the outcomes of individuals after ligament stabilization have rarely been reported. The radiographic and clinical outcomes after ligament stabilization in individuals with chronic ankle instability and medial compartment OA were investigated. Methods The study investigated 27 ankles with chronic ankle instability and medial compartment OA that underwent lateral ankle ligament reconstruction from 2007 to 2015 with a follow-up period of at least 1 year. Ligament stabilization was performed via either the modified Broström procedure (MBP) or lateral ankle reconstruction (LAR) using semitendinosus tendon allografts. ResultsThe median instability duration was 60 (range 12-480) months, and the median follow-up period was 39 (range 12-108) months. The preoperative Takakura ankle OA stage was predominantly stage I (20 patients (74.1%)), followed by stage II (five patients (18.5%)). Ankle MRI (20 ankles) revealed medial cartilage denudation in three cases (15%), cartilage thinning in nine cases (45%), osteophyte formation in ten cases (50%), and loose body formation in six cases (30%). According to the arthroscopic results, the modified Outerbridge grade was two in nine cases and four in ten cases, so these grades were the most common (37.5% and 41.7%, respectively). The MBP was performed in 14 patients, and LAR was performed in 13 patients (52% and 48%, respectively); the bone marrow stimulation procedure was performed in 15 patients (55%). The visual analogue scale score decreased from 6.0 (SD 1.6) preoperatively to 1.8 (SD 1.6) postoperatively (p = 0.000). The American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score improved from 61.9 (SD 14.2) to 89.7 (SD 6.2), and the Karlsson-Peterson score improved from 54.7 (SD 13.9) to 88.3 (SD 9.0) (p = 0.000). There were no serious complications, and all patients were satisfied. Conclusions Ligament stabilization with arthroscopic procedures for individuals with chronic ankle instability and medial ankle OA yielded significant functional outcomes with high patient satisfaction, even without radiographic improvement. Level of evidence IV.

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“…Therefore, the possible complications associated with a malleolar osteotomy can be avoided. Different surgical treatment options for OCLTs have been described in the current literature, including arthroscopic or open debridement with or without microfracture [13, 20], autologous osteochondral transplantation [7, 9], matrix‐induced autologous chondrocyte transplantation [10], and osteochondral allograft transplantation [25]. The AMIC technique is a well‐established operative treatment of OCLTs with an increasing number of clinical reports in the current literature (Supplemental Table 1) [28].…”

Section: Discussionmentioning

confidence: 99%

Open reconstruction with autologous spongiosa grafts and matrix-induced chondrogenesis for osteochondral lesions of the talus can be performed without medial malleolar osteotomy

Galla

Duensing

Kahn

et al. 2018

Knee Surg Sports Traumatol Arthrosc

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CT arthrography visualizes tissue growth of osteochondral defects of the talus after microfracture

Abstract: IV.

Cited by 12 publications

References 31 publications

Flat-panel CT arthrography for cartilage defect detection in the ankle joint: first results in vivo

Flat-panel CT arthrography for cartilage defect detection in the ankle joint: first results in vivo

Ligament stabilization improved clinical and radiographic outcomes for individuals with chronic ankle instability and medial ankle osteoarthritis

Open reconstruction with autologous spongiosa grafts and matrix-induced chondrogenesis for osteochondral lesions of the talus can be performed without medial malleolar osteotomy

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