Baseline cartilage T1ρ and T2 predicted patellofemoral joint cartilage lesion progression and patient‐reported outcomes after ACL reconstruction

Abstract

This study aims to determine if baseline T1ρ and T2 will predict cartilage morphological lesion progression in the patellofemoral joint (PFJ) and patient‐reported outcomes at 2‐year after anterior cruciate ligament (ACL) reconstruction (ACLR). Thirty‐nine ACL‐injured patients were studied at baseline and two‐year after ACLR. 3 T MR T1ρ and T2 images and Knee Injury and Osteoarthritis Outcome Score (KOOS) were acquired at both time points. Voxel‐based relaxometry (VBR) technique was used to detect local cartilage abnormalities. Patients were divided into progression and non‐progression groups based on changes of the whole‐organ magnetic resonance imaging scoring (WORMS) grading of cartilage in PFJ from baseline to 2‐year, and into lower (more pain) and higher (less pain) KOOS pain groups based on 2‐year KOOS pain scores, separately. Voxel‐based analyses of covariance were used to compare T1ρ and T2 values at baseline between the defined groups. Using VBR analysis, the progression group at 2‐year showed higher T1ρ and T2 compared with the non‐progression group at baseline, with the medial femoral condyle showing the largest areas with significant differences. At two‐year, 56% of patients were able to recover with respect to KOOS pain. The lower KOOS pain group at 2‐year showed significantly elevated T1ρ and T2 in the patella at baseline compared with the higher KOOS pain group. In conclusion, baseline T1ρ and T2 mapping, combined with VBR analysis, may help identify ACLR patients at high risk of developing progressive PFJ cartilage lesions and worse clinical symptoms 2‐year after surgery.

Postoperative quadriceps weakness and male sex are risk factors for patellofemoral articular cartilage lesions after anatomical anterior cruciate ligament reconstruction

“…Generally, the presence of cartilage damage during ACL reconstruction affects cartilage damage progression irrespective of surgery [ 1 , 7 , 32 ]. In particular, PF joint cartilage damage is aggravated after ACL reconstruction [ 8 ].…”

“…Moreover, the condition of the cartilage at the primary ACL reconstruction is important for evaluating PF cartilage lesions. The presence of cartilage lesions during ACL reconstruction is a significant factor in cartilage lesion progression, irrespective of surgery [ 1 , 7 , 32 ]. Therefore, pre-existing cartilage lesion progression should be distinguished from the occurrence of new cartilage lesions during the postoperative period.…”

Femoral cartilage ultrasound echo‐intensity is a valid measure of cartilage composition

“…[8][9][10] Additionally, early measures of cartilage composition are related to future declines in patient reported and functional outcomes following ACLR. [11][12][13][14] Despite the potential importance of MR-derived outcomes of cartilage composition as an early prognostic biomarker of OA, there are limitations in cost, accessibility, and technical expertise that prevent the widespread use of advanced compositional imaging techniques outside of well-funded research environments.…”

Patellar Dislocation in Adolescent Patients: Influence on Cartilage Properties Based on T1ρ Relaxation Times

“…12 Long T1r and T2 relaxation times at an early stage of injury to patellofemoral and tibiofemoral cartilage have been shown to be predictive of morphologically assessed progressive cartilage degradation. 1,16,27,40 Previous studies focused on first-time dislocations, 11,37 multiple dislocations, 9 and general patellar instability 14 have shown elevated T1r and T2 relaxation times for cartilage on the patella as compared with healthy controls. T1r relaxation times partially recovered with time in the acute phase after a first-time dislocation.…”