MR and CT Arthrography of the Knee

Kalke, Robyn J.; Primio, Gina A. Di; Schweitzer, Mark E.

doi:10.1055/s-0032-1304301

Cited by 51 publications

(36 citation statements)

References 62 publications

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“…As such, component rotation could not be analyzed. It is likely that the MRI-based technique provides improved imaging of the cartilage surfaces [6,9,22,44,47]. Based on the cartilage surface estimated by the surgeon with CT-based patient-specific instrumentation, deviations from the real joint surface are possible, which can result in a poorer fit.…”

Section: Discussionmentioning

confidence: 99%

Small Improvements in Mechanical Axis Alignment Achieved With MRI versus CT-based Patient-specific Instruments in TKA: A Randomized Clinical Trial

Pfitzner

Abdel

Roth

et al. 2014

Clinical Orthopaedics &Amp; Related Research

101

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Background Patient-specific instrumentation in TKA has the proposed benefits of improving coronal and sagittal alignment and rotation of the components. In contrast, the literature is inconsistent if the use of patient-specific instrumentation improves alignment in comparison to conventional instrumentation. Depending on the manufacturer, patient-specific instrumentation is based on either MRI or CT scans. However, it is unknown whether one patient-specific instrumentation approach is more accurate than the other and if there is a potential benefit in terms of reduction of duration of surgery. Questions/purposes We compared the accuracy of MRIand CT-based patient-specific instrumentation with conventional instrumentation and with each other in TKAs. The three approaches also were compared with respect to validated outcomes scores and duration of surgery. Methods A randomized clinical trial was conducted in which 90 patients were enrolled and divided into three groups: CT-based, MRI-based patient-specific instrumentation, and conventional instrumentation. The groups were not different regarding age, male/female sex distribution, and BMI. In all groups, coronal and sagittal alignments were measured on postoperative standing long-leg and lateral radiographs. Component rotation was measured on CT scans. Clinical outcomes (Knee Society and WOMAC scores) were evaluated preoperatively and at a mean of 3 months postoperatively and the duration of surgery was analyzed for each patient. MRI-and CT-based patientspecific instrumentation groups were first compared with conventional instrumentation, the patient-specific instrumentation groups were compared with each other, and all three approaches were compared for clinical outcome measures and duration of surgery. Results Compared with conventional instrumentation MRI-and CT-based patient-specific instrumentation showed higher accuracy regarding the coronal limb axis

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Section: Discussionmentioning

confidence: 99%

Small Improvements in Mechanical Axis Alignment Achieved With MRI versus CT-based Patient-specific Instruments in TKA: A Randomized Clinical Trial

Pfitzner

Abdel

Roth

et al. 2014

Clinical Orthopaedics &Amp; Related Research

101

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“…Besides MRI, CTA has been used for detection of osteochondral lesions in many joints [12, 17, 18, 28–30]. CTA of the ankle joint is still clinically relevant [16] and the diagnostic value may be underrepresented in the literature.…”

Section: Discussionmentioning

confidence: 99%

“…In the study by Chemouni et al CT arthrography showed an accuracy of 88% [31]. For detection of retropatellar osteochondral lesions, CTA performed superior compared with conventional MRI in several studies [1, 28]. For detection of osteochondral lesions at the ankle, Schmid et al reported that CTA was superior to MRA [6].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Value of CT Arthrography for Evaluation of Osteochondral Lesions at the Ankle

Kirschke

Braun

Baum

et al. 2016

BioMed Research International

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Background. To retrospectively determine the diagnostic value of computed tomography arthrography (CTA) of the ankle in the evaluation of (osteo)chondral lesions in comparison to conventional magnetic resonance imaging (MRI) and intraoperative findings. Methods. A total of N = 79 patients had CTAs and MRI of the ankle; in 17/79 cases surgical reports with statements on cartilage integrity were available. Cartilage lesions and bony defects at talus and tibia were scored according to defect depth and size by two radiologists. Statistical analysis included sensitivity analyses and Cohen's kappa calculations. Results. On CTA, 41/79 and 31/79 patients had full thickness cartilage defects at the talus and at the tibia, respectively. MRI was able to detect 54% of these defects. For the detection of full thickness cartilage lesions, interobserver agreement was substantial (0.72 ± 0.05) for CTA and moderate (0.55 ± 0.07) for MRI. In surgical reports, 88–92% and 46–62% of full thickness defects detected by CTA and MRI were described. CTA findings changed the further clinical management in 15.4% of cases. Conclusions. As compared to conventional MRI, CTA improves detection and visualization of cartilage defects at the ankle and is a relevant tool for treatment decisions in unclear cases.

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“…Arthrography can also be used to assess the status after autologous chondrocyte implantation and sometimes for assessment of anterior cruciate ligament grafts. 28 …”

Section: Articular Intervention Arthrography Indicationsmentioning

confidence: 99%

“…The most commonly used approach is the lateral patella-femoral approach but a medial patella-femoral or direct anterior approach (medial or lateral to the patellar tendon) may also be used. 28,31,32 The patient is positioned supine with the knee slightly flexed to enable the quadriceps to be relaxed. After obtaining informed consent, a sterile technique is used to infiltrate the skin and subcutaneous tissues with a small amount of appropriate local anaesthetic solution.…”

Section: Risks and Contraindicationsmentioning

confidence: 99%

Interventional articular and para-articular knee procedures

Lalam

Winn

Cassar‐Pullicino

2016

BJR

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The knee is a common area of the body to undergo interventional procedures. This article discusses image-guided interventional issues specific to the knee area. The soft tissues in and around the knee are frequently affected by sportrelated injuries and often need image-guided intervention. This article details the specific technical issues related to intervention in these soft tissues, including the iliotibial tract, fat pads, patellar tendon and other tendons, bursae and the meniscus. Most often, simple procedures such as injection and aspiration are performed without image guidance. Rarely image-guided diagnostic arthrography and therapeutic joint injections are necessary. The technique, indications and diagnostic considerations for arthrography are discussed in this article. Primary bone and softtissue tumours may involve the knee and adjacent soft tissues. Image-guided biopsies are frequently necessary for these lesions; this article details the technical issues related to image-guided biopsy around the knee. A number of newer ablation treatments are now available, including cryoablation, high-frequency ultrasound and microwave ablation. Radiofrequency ablation, however, still remains the most commonly employed ablation technique. The indications, technical and therapeutic considerations related to the application of this technique around the knee are discussed here. Finally, we briefly discuss some newer, but as of yet, unproven image-guided interventions for osteochondral lesions and Brodie's abscess. INTRODUCTIONThe knee is one of the commonest joints affected by osteoarthritis and other internal derangements, such as ligament and meniscal pathology, which may need imageguided and surgical management. The tissues around the knee are also a common site for bone tumours and intervention in the form of biopsy or ablation is often performed around the knee. Interventions such as injections are routinely performed in the knee and, in most instances, are performed in the outpatient setting without any image guidance. In this article, we discuss issues related to imageguided intervention specific to the knee joint. Detailed descriptions of the techniques and the merits of most of the procedures are described elsewhere in this issue. We also discuss newer techniques such as drainage of abscess and retrograde drilling of osteochondral lesions, even though there is sparse literature on these procedures and the evidence is limited currently.

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MR and CT Arthrography of the Knee

Cited by 51 publications

References 62 publications

Small Improvements in Mechanical Axis Alignment Achieved With MRI versus CT-based Patient-specific Instruments in TKA: A Randomized Clinical Trial

Small Improvements in Mechanical Axis Alignment Achieved With MRI versus CT-based Patient-specific Instruments in TKA: A Randomized Clinical Trial

Diagnostic Value of CT Arthrography for Evaluation of Osteochondral Lesions at the Ankle

Interventional articular and para-articular knee procedures

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