Acute and Stress-related Injuries of Bone and Cartilage: Pertinent Anatomy, Basic Biomechanics, and Imaging Perspective

Pathria, Mini N.; Chung, Christine B.; Resnick, Donald

doi:10.1148/radiol.16142305

Cited by 112 publications

(72 citation statements)

References 118 publications

(111 reference statements)

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“…During ACL injury, the impacts of bones also often result in artilage and meniscus damages (42). The compression can lead to chondrocyte death and matrix injury (43). At biopsies in patients with acute ACL rupture, histological examinations have shown chondrocyte and matrix degeneration, and biochemical variations in the cartilage overlying BMEL (17).…”

Section: Discussionmentioning

confidence: 99%

Bone marrow edema-like lesions (BMELs) are associated with higher T1ρ and T2 values of cartilage in anterior cruciate ligament (ACL)-reconstructed knees: a longitudinal study

Gong

Pedoia

Facchetti

et al. 2016

Quant. Imaging Med. Surg.

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Background: To evaluate the longitudinal changes of bone marrow edema-like lesions (BMELs) in patients after anterior cruciate ligament (ACL) reconstruction and to investigate the effect of BMELs on cartilage matrix composition changes measured using MR T 1ρ and T 2 mapping. Methods:Patients with acute ACL tear were enrolled in a prospective study. MR imaging was performed at baseline (before surgeries) and at 6-month, 1-year and 2-year after ACL reconstruction. MR imaging included sagittal high-resolution, 3D fast spin-echo (CUBE) sequences for BMEL evaluation, and 3D T 1ρ mapping and T 2 mapping for cartilage assessment. BMELs were assessed using whole-organ magnetic resonance imaging score (WORMS), and the volume of BMELs was measured by a semi-automatic method.Generalized estimating equation (GEE) was used to explore association between BMELs at baseline and cartilage changes during follow-up.Results: Fifty four patients were included in the present study and 39 patients had completed 2-year follow-up. BMELs were noted in 42 injured knees (77.8%) with 105 lesions and in 7 contralateral knees (13.0%) with 9 lesions (χ 2 =45.763, P<0.001) at the baseline. The WORMS and volume of BMELs of the injured knees were 2.36±0.65 and 386.98±382.54 mm 3 (r=0.681, P<0.001), respectively. 87 BMELs were found at baseline in 34 patients (87.2%) of the 39 patients who had completed 2 years follow-up. During the follow-up, 18 (20.7%), 12 (13.8%), and 5 (5.7%) baseline lesions were still seen at 6-month, 1-year and 2-year, respectively. The changes of BMELs prevalence regarding bone compartments over time points were statistically significant (χ 2 =163.660, P<0.001). Except T 2 value at 6 months, T 1ρ and T 2 values of cartilage overlying baseline BMELs in the injured knees were higher than that of anatomically matched cartilage in the contralateral knees at baseline and each follow-up time-point. In the injured knees, GEE analysis showed that baseline BMELs were significantly associated with higher T 1ρ and T 2 values of cartilage after adjustment of age, gender, body mass index (BMI), effusion and meniscus tear. The association between BMELs and Knee Injury and Osteoarthritis Outcome Scores (KOOS) scores was not statistically significant.Conclusions: BMEL is a common finding in patients with acute ACL injury and resolves rapidly over time after ACL reconstruction. It is often associated with increased T 1ρ and T 2 values of cartilage. BMEL at baseline is an independent predictor for faster cartilage degeneration during follow-up.

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Section: Discussionmentioning

confidence: 99%

Bone marrow edema-like lesions (BMELs) are associated with higher T1ρ and T2 values of cartilage in anterior cruciate ligament (ACL)-reconstructed knees: a longitudinal study

Gong

Pedoia

Facchetti

et al. 2016

Quant. Imaging Med. Surg.

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“…Several techniques are available to assess the integrity of cartilage glycosaminoglycan, including sodium MR imaging, delayed gadolinium-enhanced MR imaging of cartilage, and T1 ρ imaging. To assess collagen orientation, quantitative T2 mapping is most often utilized [11,12].…”

Section: Incidence Symptomatology Diagnosis and Classification Of Cmentioning

confidence: 99%

Management of Knee Cartilage Defects with the Autologous Matrix-Induced Chondrogenesis (AMIC) Technique

Hantes¹,

Fyllos²

2018

Cartilage Repair and Regeneration

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The arthroscopic findings of knee articular cartilage lesions are reported to be as high as 60%, although only a fragment of these are considered to be symptomatic. Such lesions are believed to accelerate the onset of arthritis. Long-term results of the microfracture technique for chondral and osteochondral defects of the knee cartilage are not satisfactory. The autologous matrix induced chondrogenesis (AMIC) technique offers a promising alternative as an effective cartilage repair procedure in the knee resulting in stable clinical results and with a wide range of indications. An extensive literature review has been performed aiming at providing the rationale behind AMIC, to report clinical results of AMIC and to compare AMIC with other chondrogenesis techniques. Finally, we comment on the appropriate surgical technique and its indications, since the number of onestep arthroscopic procedure proposals is steadily increasing.

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“…For some time, entheseal changes were thought to be indicators of occupational stress, allowing bioarchaeologists to reconstruct past lifeways and formulate conclusions about repetitive activities/work behaviour from diagnoses of robusticity and stress lesions (e.g., al‐Oumaoui, Jiménez‐Brobeil, & du Souich, ; Kennedy, ). The application of biomechanics and bone remodelling theory to entheseal changes led to the deduction that entheseal changes are created by repetitive motions producing strain on the muscle attachment sites, causing an increase in blood flow and resulting in remodelling of entheses (Lieberman, Pearson, Polk, Demes, & Crompton, ; Pathria, Chung, & Resnick, ). Formalized scoring systems, such as Hawkey and Merbs () and the new Coimbra method (e.g., Henderson, Wilczak, & Mariotti, ), have allowed researchers to capture and measure the remodelling process of bone and to make conclusions regarding the severity and, thusly thought, high level of activity in current and past populations.…”

Section: Introductionmentioning

confidence: 99%

“…sites, causing an increase in blood flow and resulting in remodelling of entheses (Lieberman, Pearson, Polk, Demes, & Crompton, 2003;Pathria, Chung, & Resnick, 2016). Formalized scoring systems, such as Hawkey and Merbs (1995) and the new Coimbra method (e.g., Henderson, Wilczak, & Mariotti, 2017), have allowed researchers to capture and measure the remodelling process of bone and to make conclusions regarding the severity and, thusly thought, high level of activity in current and past populations.…”

mentioning

confidence: 99%

“…However, there is an incomplete understanding of bone remodelling, and by extension entheseal changes, where how much remodelling occurs due to either microtrauma or repetitive motions is unknown (Chapurlat & Delmas, 2009;Pathria et al, 2016). Additionally, the amount of remodelling occurring after maturity has not been determined (Hadjadakis & Androulakis, 2006;Weiss, Corona, & Schultz, 2012).…”

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confidence: 99%

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Entheseal changes and demographic/health indicators in the upper extremity of modern Americans: Associations with age and physical activity

Godde

Taylor

Gutierrez

2018

Intl J of Osteoarchaeology

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The purpose of this study is to further the understanding of the relationship between age and entheseal changes by using trends in living Americans compared to skeletal remains of modern Americans, and applying the knowledge to the bioarchaeological record. Documentation of age, activity level, body mass index, stature, and body mass was combined with entheseal change scores gathered from the upper extremity to statistically test the relationship between age and entheseal change with and without controls of documented demographic and health factors. An active subsample was constructed using self‐reported repetitive activities and discernment of position within stated career. Fibrocartilaginous entheses reported in the literature to be better suited to estimate occupation were separated from other entheses. A series of Cochran–Mantel–Hanzel and analysis of variance‐based tests were applied to the data. Interobserver reliability was also examined with a linear‐weighted Cohen's kappa. Statistical analysis shows only 1 enthesis has a significant positive relationship with age and 2 with activity. Body mass index and body mass were associated with 9 entheses that were spread across the occupation‐associated fibrocartilaginous entheses and all other entheses. Interobserver reliability ranged from low to substantial agreement. Interobserver error estimates suggest some entheses are more reliable than others. Results provide little support for a relationship between age and entheseal changes and activity and entheseal changes, which partially coincides with previous research. An increase in activity with age in our sample, around the age of retirement, mirrors trends in living Americans and supports our conclusions. For bioarchaeologists, these results suggest interpretations of entheses should be cautiously applied and revolve around body size rather than activity levels.

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Acute and Stress-related Injuries of Bone and Cartilage: Pertinent Anatomy, Basic Biomechanics, and Imaging Perspective

Cited by 112 publications

References 118 publications

Bone marrow edema-like lesions (BMELs) are associated with higher T1ρ and T2 values of cartilage in anterior cruciate ligament (ACL)-reconstructed knees: a longitudinal study

Bone marrow edema-like lesions (BMELs) are associated with higher T1ρ and T2 values of cartilage in anterior cruciate ligament (ACL)-reconstructed knees: a longitudinal study

Management of Knee Cartilage Defects with the Autologous Matrix-Induced Chondrogenesis (AMIC) Technique

Entheseal changes and demographic/health indicators in the upper extremity of modern Americans: Associations with age and physical activity

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