Ultrasound properties of articular cartilage immediately after osteochondral grafting surgery: in cases of traumatic cartilage lesions and osteonecrosis

Abstract

Although osteochondral grafting surgery is believed to replace damaged cartilage with healthy-looking normal cartilage, no study focuses on ultrasound quantification of those cartilage immediately after the surgery. It is unknown whether the ultrasound properties of damaged cartilage from trauma or osteonecrosis are same with each other. We have examined ultrasound properties of damaged cartilage, adjacent intact cartilage and plug cartilage during osteochondral grafting surgery for 15 knees of 15 patients, mean age of 43.4 (range, 14-61) years. Results showed that signal intensities of ultrasound (a measure of superficial cartilage integrity) of intact cartilage, damaged cartilage, and plug cartilage were 1.91 (arbitrary unit), 0.40, and 2.13, respectively, in 11 knees of 11 patients of traumatic cartilage lesions. Interval between signals of ultrasound (a parameter related to thickness) were 2.79 (ls), 1.90, and 2.85, respectively. The signal intensity and the interval between signals of plug cartilage were 533% (P \ 0.01) and 150% (P \ 0.01) of damaged cartilage, respectively.In four knees of four patients of osteonecrosis, the signal intensities of intact cartilage, damaged cartilage, and plug cartilage were 1.25, 0.30, and 1.39, respectively. The interval between signals were 2.36, 2.00, and 2.69, respectively. The signal intensity and the interval between signals of plug cartilage were 463% (P \ 0.01) and 135% (P \ 0.05) of damaged cartilage. We conclude that ultrasound properties of the damaged cartilage from trauma or osteonecrosis did not differ a lot especially in the late stages of osteonecrosis and that the osteochondral grafting surgery replaced the damaged cartilage with plug cartilage that had greater superficial cartilage integrity and greater thickness parameter immediately after the surgery. Longterm effect of the osteochondral grafting surgery should be verified in further study.

Disuse histological changes of an unloading environment on joint components in rat knee joints

“…Clinically, there are situations wherein the surgical lower limb must remain unloaded after surgery for fractures or cartilage defects [ 40 , 41 ]. In such situations, early or excessive loading can exert an adverse effect on tissue repair, such as irregularities, displacement, and subsidence [ 26 , 42 , 43 ]. Therefore, the use of continuous passive motion and exercise of the range of motion by physical therapists may be useful for histological maintenance and to inhibit disuse histopathological changes to the joint components.…”

Resection-Induced Leveling of Elevated Plug Cartilage in Osteochondral Autologous Transplantation of the Knee Achieves Acceptable Clinical Results

“…OAT has been performed for the past 2 decades in our hospital. 19,21,23-26 Although we understand that perfect plug congruity in terms of height, tilt, and orientation during harvesting and grafting is required to achieve ideal healing, graft incongruity sometimes occurs regardless of how carefully the operation was performed. In a surface congruity study, Nakagawa et al 25 stated that protuberant plugs of the medial femoral condyle cause softening and fibrillation of the opposite medial tibial cartilage and that patients continue to feel the catching sensation.…”

Ultrasonic probe is useful for in vivo quantitative assessment of medial femoral condyle articular cartilage

“…Several parameters have been applied for quantitative analysis of cartilage [5, 18, 29]; one of which is the maximum magnitude obtained from wavelet transform analysis [11]. Kuroki et al evaluated the ultrasound properties of damaged cartilage following trauma or osteonecrosis that required osteochondral grafting surgery, as compared with apparently healthy intact cartilage adjacent to the lesions [17]. It was found that the signal intensity (maximum magnitude) of damaged cartilage was lower than that of adjacent intact cartilage and that the signal intensity values of intact cartilage were widely distributed.…”