New approach for predictive measurement of knee cartilage defects with three-dimensional printing based on CT-arthrography: A feasibility study

Michalik, Roman; Schrading, Simone; Dirrichs, Timm; Prescher, Andreas; Kuhl, Christiane K.; Tingart, Markus; Rath, Björn

doi:10.1016/j.jor.2016.10.013

Cited by 7 publications

(2 citation statements)

References 31 publications

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“…In contrast, the high accuracy of imaging methods for estimating the exact diameters of articular lesions has been demonstrated in a handful of prior studies 28,32,34,37-39 . Recent advances have led to marked improvement in the determination of cartilage defect size with use of both high-resolution MRI and CTA 37,40 .…”

Section: Discussionmentioning

confidence: 99%

Image-Guided Chondrocyte Harvesting for Autologous Chondrocyte Implantation

Zikria

Hafezi-Nejad

Patten

et al. 2019

JBJS OA

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Background: Autologous chondrocyte implantation (ACI), a promising modality for repairing full-thickness cartilage defects, requires 2 consecutive arthroscopic procedures for chondrocyte harvesting and implantation. In the present study, we assessed the feasibility and efficacy of image-guided chondrocyte harvesting as an alternative to arthroscopic biopsy. Methods: We induced full-thickness cartilage defects in 10 human cadaveric knees. Computed tomographic arthrography (CTA) was performed following the intra-articular administration of Omnipaque 350 to measure the diameters of the induced cartilage defects. Subsequently, 2 independent operators conducted CTA-guided chondrocyte harvesting (from the medial and lateral trochlear ridges) in each knee. The time for chondrocyte harvesting, accuracy (distance between the predefined target on CTA and the final insertion site of the needle), and number of needle readjustments were recorded. In the institutional review board-approved clinical study, informed consent was obtained and chondrocyte harvesting was performed both with use of a conventional arthroscopic biopsy method and with use of a needle through an arthroscopy access site in 10 subjects for whom ACI was indicated. The samples were processed and cultured blindly, and the quantity and quality of the samples were determined. Results: CTA measurements of full-thickness cartilage defects showed high to perfect absolute agreement and consistency when compared with direct measurements (overall interclass correlation coefficient, 0.933 to 0.983; p < 0.05). For both operators, image-guided chondrocyte harvesting from the lateral ridge was more accurate (p = 0.007 and 0.040) and faster (p = 0.056 and 0.014) in comparison with harvesting from the medial ridge. In the clinical study, no significant difference was observed for the growth index of samples between the needle-harvest and conventional methods (p = 0.897). Conclusions: CTA can be used for precise measurement of full-thickness cartilage defects. Image-guided chondrocyte harvesting is a viable alternative to traditional arthroscopic biopsy for ACI. Clinical Relevance: We recognize the current pivotal role of arthroscopic biopsy, as a part of ACI, for chondrocyte harvesting as well as for delineating the nature of the lesion. However, on the basis of our results, image-guided chondrocyte retrieval may obviate the need for arthroscopic biopsy in some patients in the future.

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Section: Discussionmentioning

confidence: 99%

Image-Guided Chondrocyte Harvesting for Autologous Chondrocyte Implantation

Zikria

Hafezi-Nejad

Patten

et al. 2019

JBJS OA

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“…37 The accuracy of cartilage defect measurements was found better on CT arthrography than MRI. 38 For soft tissue visualization, meniscus, and cartilage visualization, CT will not replace MRI, nevertheless the very good contrast between bone structure and soft tissue that we can find using CT allows the use of pertinent segmentation methods. Contrary to MRI, the main drawback of our approach is the inability to differentiate cartilage and meniscus influence on JS narrowing which is known to be associated with both cartilage and meniscal damages.…”

Section: Discussionmentioning

confidence: 99%

Three‐dimensional mapping of the joint space for the diagnosis of knee osteoarthritis based on high resolution computed tomography: Comparison with radiographic, outerbridge, and meniscal classifications

Mezlini-Gharsallah

Youssef

et al. 2018

Journal Orthopaedic Research

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One of the most important characteristic of knee osteoarthritis (OA) is the joint space (JS) width narrowing. Measurements are usually performed on two dimensional (2D) X‐rays. We propose and validate a new method to assess the 3D joint space at the medial knee compartment using high resolution peripheral computed tomography images. A semi‐automated method was developed to obtain a distance 3D map between femur an tibia with the following parameters: volume, minimum, maximum, mean, standard deviation, median, asymmetry, and entropy. We analyzed 71 knee specimens (mean age: 85 years), radiographs were performed for the Kellgren Lawrence (KL) score grading. In a subgroup of 41 specimens, the histopathological Outerbridge and meniscal classifications were performed and then cores were harvested from the tibial plateau in three different positions (posterior, central, and peripheral) and imaged at 10 µm of resolution to measure the cartilage thickness. Minimum, maximum, mean, and median were statistically lower and entropy higher between knee specimens classified as KL = 0 and KL = 3–4. Gr1 and 2 were statistically different from Gr3‐4 for minimum, asymmetry, entropy using the Outerbridge classification and Gr1 was statistically different from Gr3–4 using the meniscal classification. Asymmetry, minimum, mean, median and entropy were significantly correlated with cartilage thickness. Parameters extracted from a 3D map of the medial joint space indicate local variations of JS and are related to local measurements of tibial cartilage thickness, and could be consequently useful to identify early OA. © 2018 The Authors. Journal of Orthopaedic Research® Published by Wiley Periodicals, Inc. on behalf of Orthopaedic Research Society. J Orthop Res 36:2380–2391, 2018.

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Computed Tomography (CT) and CT Arthrography

Pattamapaspong¹,

Peh²

2023

Imaging of the Knee

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New approach for predictive measurement of knee cartilage defects with three-dimensional printing based on CT-arthrography: A feasibility study

Cited by 7 publications

References 31 publications

Image-Guided Chondrocyte Harvesting for Autologous Chondrocyte Implantation

Image-Guided Chondrocyte Harvesting for Autologous Chondrocyte Implantation

Three‐dimensional mapping of the joint space for the diagnosis of knee osteoarthritis based on high resolution computed tomography: Comparison with radiographic, outerbridge, and meniscal classifications

Computed Tomography (CT) and CT Arthrography

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