Initial results of in vivo high-resolution morphological and biochemical cartilage imaging of patients after matrix-associated autologous chondrocyte transplantation (MACT) of the ankle

Quirbach, Sebastian; Trattnig, Siegfried; Marlovits, Stefan; Zimmermann, Valentin; Domayer, Stephan; Dorotka, Ronald; Mamisch, T.C.; Bohndorf, Klaus; Welsch, Goetz H.

doi:10.1007/s00256-009-0682-1

Cited by 71 publications

(70 citation statements)

References 50 publications

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“…After MACI at the ankle joint cartilage repair tissue showed no significant difference in T2 and T2* relaxation times compared to the control cartilage, but it showed a higher diffusivity [179]. Apprich et al examined cartilage repair at the ankle 5 years after Mfx and 4 years after MACI using DWI [180].…”

Section: Resultsmentioning

confidence: 99%

Cartilage Repair Surgery: Outcome Evaluation by Using Noninvasive Cartilage Biomarkers Based on Quantitative MRI Techniques?

Jungmann

Baum

Bauer

et al. 2014

BioMed Research International

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Background. New quantitative magnetic resonance imaging (MRI) techniques are increasingly applied as outcome measures after cartilage repair. Objective. To review the current literature on the use of quantitative MRI biomarkers for evaluation of cartilage repair at the knee and ankle. Methods. Using PubMed literature research, studies on biochemical, quantitative MR imaging of cartilage repair were identified and reviewed. Results. Quantitative MR biomarkers detect early degeneration of articular cartilage, mainly represented by an increasing water content, collagen disruption, and proteoglycan loss. Recently, feasibility of biochemical MR imaging of cartilage repair tissue and surrounding cartilage was demonstrated. Ultrastructural properties of the tissue after different repair procedures resulted in differences in imaging characteristics. T2 mapping, T1rho mapping, delayed gadolinium-enhanced MRI of cartilage (dGEMRIC), and diffusion weighted imaging (DWI) are applicable on most clinical 1.5 T and 3 T MR scanners. Currently, a standard of reference is difficult to define and knowledge is limited concerning correlation of clinical and MR findings. The lack of histological correlations complicates the identification of the exact tissue composition. Conclusions. A multimodal approach combining several quantitative MRI techniques in addition to morphological and clinical evaluation might be promising. Further investigations are required to demonstrate the potential for outcome evaluation after cartilage repair.

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Section: Resultsmentioning

confidence: 99%

Cartilage Repair Surgery: Outcome Evaluation by Using Noninvasive Cartilage Biomarkers Based on Quantitative MRI Techniques?

Jungmann

Baum

Bauer

et al. 2014

BioMed Research International

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“…Only 50% of the patients returned to their previous sporting activities. In a separate study by Quirbach et al, who evaluated twelve patients after matrixinduced autologous chondrocyte implantation, T2 and T2* MRI relaxation times revealed a repair tissue that was not significantly different from the tissue in a healthy control group 77 .…”

Section: Matrix-associated Techniquementioning

confidence: 98%

Operative Treatment of Osteochondral Lesions of the Talus

Murawski

Kennedy

2013

Journal of Bone and Joint Surgery

231

202

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➤ Osteochondral lesions of the talus are common injuries in recreational and professional athletes, with up to 50% of acute ankle sprains and fractures developing some form of chondral injury. Surgical treatment paradigms aim to restore the articular surface with a repair tissue similar to native cartilage and to provide long-term symptomatic relief.➤ Arthroscopic bone-marrow stimulation techniques, such as microfracture and drilling, perforate the subchondral plate with multiple openings to recruit mesenchymal stem cells from the underlying bone marrow to stimulate the differentiation of fibrocartilaginous repair tissue in the defect site. The ability of fibrocartilage to withstand mechanical loading and protect the subchondral bone over time is a concern.➤ Autologous osteochondral transplantation techniques replace the defect with a tubular unit of viable hyaline cartilage and bone from a donor site in the ipsilateral knee. In rare cases, a graft can also be harvested from the ipsilateral talus or contralateral knee. The limitations of donor site morbidity and the potential need for an osteotomy about the ankle should be considered. Some anterior or far posterior talar lesions can be accessed without arthrotomy or with a plafondplasty.➤ Osteochondral allograft transplantation allows an osteochondral lesion with a large surface area to be replaced with a single unit of viable articular cartilage and subchondral bone from a donor that is matched to size, shape, and surface curvature. The best available evidence suggests that this procedure should be limited to large-volume cystic lesions or salvage procedures.➤ Autologous chondrocyte implantation techniques require a two-stage procedure, the first for chondrocyte harvest and the second for implantation in a periosteum-covered or matrix-induced form after in vivo culture expansion. Theoretically, the transplantation of chondrocyte-like cells into the defect will result in hyaline-like repair tissue.

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“…Quirsbach et al [28] utilized 3 T MRI to examine 10 volunteers and 12 patients with matrix-associated autologous chondrocyte transplantation (MACT) at the talus, and found significant differences in diffusivity between the MACT-RT and healthy cartilage, whereas T2 and T2* did not show significant results. Apprich et al, who compared the diffusion values of MACT and microfracture therapy (MFX) of the talus [30], found that while there was no difference in diffusion quotients between reference cartilage and MACT-RT, significantly higher diffusion quotients were found in the MFX-RT.…”

Section: Discussionmentioning

confidence: 96%

“…This problem is further aggravated if quantitative imaging sequences are used. With the increased signal-to-noise ratio and spatial resolution of 3 T MRI scanners, biochemical imaging of the ankle cartilage has become feasible [28,29].…”

Section: Discussionmentioning

confidence: 99%

“…More feasible for musculoskeletal applications such as the evaluation of cartilage are sequences based on a steady-state free-precession technique offering a higher resolution. Instead of a SSFP sequence that was used in the work of Quirbach [28], we used a truly diffusion-weighted 3D double-echo steady-state (dwDESS) sequence. The great advantage of the dwDESS technique is the independence of the diffusion coefficient with regard to T1 and T2 relaxation values, thereby allowing the calculation of absolute diffusion values.…”

Section: Discussionmentioning

confidence: 99%

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Characterization of the collagen component of cartilage repair tissue of the talus with quantitative MRI: comparison of T2 relaxation time measurements with a diffusion-weighted double-echo steady-state sequence (dwDESS)

et al. 2014

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Initial results of in vivo high-resolution morphological and biochemical cartilage imaging of patients after matrix-associated autologous chondrocyte transplantation (MACT) of the ankle

Cited by 71 publications

References 50 publications

Cartilage Repair Surgery: Outcome Evaluation by Using Noninvasive Cartilage Biomarkers Based on Quantitative MRI Techniques?

Cartilage Repair Surgery: Outcome Evaluation by Using Noninvasive Cartilage Biomarkers Based on Quantitative MRI Techniques?

Operative Treatment of Osteochondral Lesions of the Talus

Characterization of the collagen component of cartilage repair tissue of the talus with quantitative MRI: comparison of T2 relaxation time measurements with a diffusion-weighted double-echo steady-state sequence (dwDESS)

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