T2-mapping at 3 T after microfracture in the treatment of osteochondral defects of the talus at an average follow-up of 8 years

Zühlke, David; Plaas, Christian; Ewig, Marc; Calließ, Tilman; Stukenborg-Colsman, Christina; Thermann, Hajo

doi:10.1007/s00167-014-2913-9

Cited by 30 publications

(43 citation statements)

References 29 publications

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“…High point estimates were supported by acceptable 95%CI lower bounds, which confirmed that acceptable agreement could be obtained with limited interference from between‐person variability. Intra‐rater reliability in the present study is also comparable to point estimates reported previously for T2* mapping of knee cartilage and agrees with reader reliability established with other techniques such as standard T2 or diffusion‐weighted imaging of ankle or knee cartilage (i.e., ICCs ranging 0.8–0.9) …”

Section: Discussionsupporting

confidence: 90%

In vivo deformation of thin cartilage layers: Feasibility and applicability of T2* mapping

Ginckel

Witvrouw

2015

J. Orthop. Res.

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The objectives of this study were as follows: (i) to assess segmentation consistency and scan precision of T2 Ã mapping of human tibio-talar cartilage, and (ii) to monitor changes in T2 Ã relaxation times of ankle cartilage immediately following a clinically relevant in vivo exercise and during recovery. Using multi-echo gradient recalled echo sequences, averaged T2 Ã values were calculated for tibio-talar cartilage layers in 10 healthy volunteers. Segmentation consistency and scan precision were determined from two repeated segmentations and two repeated acquisitions with repositioning, respectively. Subsequently, acute in vivo cartilage loading responses were monitored by calculating averaged tibio-talar T2 Ã values at rest, immediately after (i.e., deformation) and at 15 min (i.e., recovery) following a 30-repetition knee bending exercise. Precision errors attained 4-6% with excellent segmentation consistency point estimates (i.e., intra-rater ICC of 0.95) and acceptable limits of confidence. At deformation, T2 Ã values were increased in both layers [þ16.1 (10.7)%, p ¼ 0.004 and þ17.3 (15.3)%, p ¼ 0.023, for the talus and tibia, respectively] whereas during recovery no significant changes could be established when comparing to baseline [talar cartilage: þ5.2 (8.2)%, p ¼ 0.26 and tibial cartilage: þ6.6 (10.4)%, p ¼ 0.23]. T2 Ã mapping is a viable method to monitor deformational behavior in thin cartilage layers such as ankle cartilage. Longitudinal changes in T2 Ã can be reliably appraised and require at least 4-6% differences to ascertain statistical significance. The ability to detect considerable change even after non-strenuous loading events, endorses T2 Ã mapping as an innovative method to evaluate the effects of therapeutic exercise on thin cartilage layers. ß

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Section: Discussionsupporting

confidence: 90%

In vivo deformation of thin cartilage layers: Feasibility and applicability of T2* mapping

Ginckel

Witvrouw

2015

J. Orthop. Res.

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“…High point estimates were supported by acceptable 95%CI lower bounds which confirmed that good agreement could be obtained with limited interference from between‐person variability. Intra‐rater reliability for T2* in the STJ is comparable to point estimates reported for knee cartilage and with the use of other techniques such as standard T2 (i.e., ICCs ranging 0.8–0.9) . Additionally, precision errors after repositioning equaled on average 3–4% (i.e., ∼0.8 ms in this sample).…”

Section: Discussionsupporting

confidence: 78%

“…First, between‐reader reliability would have provided a more comprehensive view on method feasibility. Nevertheless, our feasibility constructs are in close agreement with T2 or T2* mapping in the talocrural or knee joint, which have proved to reveal acceptable inter‐reader reliability estimates . We also opted to evaluate method feasibility for full thickness layers only and did not subdivide the posterior STJ into additional sub‐compartments as is commonly performed in similar study set‐ups of hip or knee cartilage imaging.…”

Section: Discussionmentioning

confidence: 76%

T2* mapping of subtalar cartilage: Precision and association between anatomical variants and cartilage composition

Ginckel

Mits

Bennell

et al. 2016

Journal Orthopaedic Research

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Hindfoot arthritis is an important contributor to foot pain and physical disability. While the subtalar joint (STJ) is most frequently affected, anatomical variants such as facet configuration were suggested to further STJ cartilage deterioration. T2* mapping enables detection of ultra-structural cartilage change, particularly in thin cartilage layers, but its feasibility in the STJ has not yet been evaluated. The purpose of this study was to evaluate segmentation consistency and inter-scan short-term precision error of T2* mapping of talocalcaneal cartilage and to investigate the relationship between facet configuration and STJ T2* values. Using 3Tesla morphological magnetic resonance imaging, STJ configuration was categorized according to the degree of fusion between anterior, medial, or posterior facets. Subsequently, two repeats of multi-echo gradient recalled echo sequences were performed to obtain T2* maps with repositioning. Segmentation consistency of T2* values attained an ICC of 0.90 (95%CI 0.69-0.99). Precision errors comprised a coefficient of variation (CV) ranging 0.01-0.05, corresponding to a root mean square CV of 0.03-0.04. A 2-joint configuration type (i.e., fused anterior-medial facets) was significantly associated with a decrease in posterior facet T2* values (β = -0.6, p = 0.046). STJ T2* mapping is a reliable method requiring at least a 4% difference within people to enable detection of significant change. Anatomical variants in STJ configuration were associated with T2* values with the more stable 3-joint types exhibiting more favorable cartilage outcomes. Longer-term larger-scaled studies focusing on arthritis pathology are needed to further support the use of T2* mapping in hindfoot disease monitoring. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1969-1976, 2016.

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“…The question of this study therefore is: to what extent the defect is filled with bone after debridement and microfracture? The hypotheses are [ 19 ] the defect dimensions will reduce 1 year after debridement and microfracture and [ 20 ] the defect dimensions shortly after the surgery are increased by debridement and microfracture. The secondary purpose is to determine whether defect size and bony healing are determinants of clinical outcome.…”

Section: Introductionmentioning

confidence: 99%

Computed tomography analysis of osteochondral defects of the talus after arthroscopic debridement and microfracture

Reilingh

Bergen

Blankevoort

et al. 2015

Knee Surg Sports Traumatol Arthrosc

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PurposeThe primary surgical treatment of osteochondral defects (OCD) of the talus is arthroscopic debridement and microfracture. Healing of the subchondral bone is important because it affects cartilage repair and thus plays a role in pathogenesis of osteoarthritis. The purpose of this study was to evaluate the dimensional changes and bony healing of talar OCDs after arthroscopic debridement and microfracture.MethodsFifty-eight patients with a talar OCD were treated with arthroscopic debridement and microfracture. Computed tomography (CT) scans were obtained at baseline, 2 weeks postoperatively, and 1 year postoperatively. Three-dimensional changes and bony healing were analysed on CT scans. Additionally, clinical outcome was measured with the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and numeric rating scales (NRS) for pain.ResultsAverage OCD size increased significantly (p < 0.001) in all directions from 8.6 (SD 3.6) × 6.3 (SD 2.6) × 4.8 (SD 2.3) mm (anterior–posterior × medial–lateral × depth) preoperatively to 11.3 (SD 3.4) × 7.9 (SD 2.8) × 5.8 (SD 2.3) mm 2 weeks postoperatively. At 1-year follow-up, average defect size was 8.3 (SD 4.2) × 5.7 (SD 3.0) × 3.6 (SD 2.4) mm. Only average defect depth decreased significantly (p < 0.001) from preoperative to 1 year postoperative. Fourteen of the 58 OCDs were well healed. No significant differences in the AOFAS and NRS-pain were found between the well and poorly healed OCDs.ConclusionArthroscopic debridement and microfracture of a talar OCD leads to an increased defect size on the direct postoperative CT scan but restores at 1-year follow-up. Only fourteen of the 58 OCDs were filled up completely, but no differences were found between the clinical outcomes and defect healing at 1-year follow-up.Level of evidenceIV.

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T2-mapping at 3 T after microfracture in the treatment of osteochondral defects of the talus at an average follow-up of 8 years

Abstract: IV.

Cited by 30 publications

References 29 publications

In vivo deformation of thin cartilage layers: Feasibility and applicability of T2* mapping

In vivo deformation of thin cartilage layers: Feasibility and applicability of T2* mapping

T2* mapping of subtalar cartilage: Precision and association between anatomical variants and cartilage composition

Computed tomography analysis of osteochondral defects of the talus after arthroscopic debridement and microfracture

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