scholarly journals Radiofrequency Chondroplasty May Not Have a Long-Lasting Effect in the Treatment of Concomitant Grade II Patellar Cartilage Defects in Humans

2020 ◽  
Vol 9 (4) ◽  
pp. 1202
Author(s):  
Ulrich Koller ◽  
Bernhard Springer ◽  
Colleen Rentenberger ◽  
Pavol Szomolanyi ◽  
Wenzel Waldstein ◽  
...  
Keyword(s):  
Pilot Study ◽  
High Resolution ◽  
T2 Mapping ◽  
Cartilage Damage ◽  
Small Sample ◽  
Cartilage Tissue ◽  
Cartilage Defects ◽  
Lasting Effect ◽  
Patellar Cartilage ◽  
Grade Ii

The effect of radiofrequency chondroplasty on cartilage tissue is not well studied. This prospective pilot study investigates the effect of radiofrequency chondroplasty on International Cartilage Repair Society (ICRS) grade II patellar cartilage defects using high-resolution magnetic resonance imaging (MRI) with T2 mapping. Six consecutive patients were treated for ICRS grade II patellar cartilage defects using radiofrequency chondroplasty. Before surgery and at defined follow-ups (2 weeks, 4 and 12 months) a high-resolution morphological 3 Tesla MRI with quantitative T2 mapping was performed. At baseline MRI, global T2 values of cartilage defects were increased (46.8 ms ± 9.7) compared to healthy cartilage (35.2 ms ± 4.5) in the same knee which served as reference. Two weeks after treatment, global T2 values (39.2 ms ± 7.7) of the defect areas decreased. However, global T2 values of the defect areas increased beyond the preoperative levels at 4 months (47.4 ms ± 3.1) and 12 months (51.5 ms ± 5.9), respectively. Zonal T2 mapping revealed that the predominant changes in T2 values occurred at the superficial cartilage layer. T2 mapping appears to be an ideal method to monitor cartilage degeneration after chondroplasty. Based on the small sample size of this pilot study, radiofrequency chondroplasty may cause cartilage damage and may not have a long-lasting effect in the treatment of grade II patellar cartilage defects. In five out of six patients, postoperative cartilage damage was observed on quantitative MRI. This study was therefore terminated before completion. We recommend only addressing the pathology which indicated arthroscopy and leaving concomitant cartilage lesions untreated.

scholarly journals Potential predictive value of axial T2 mapping at 3 Tesla MRI in patients with untreated patellar cartilage defects over a mean follow-up of four years

2020 ◽  
Vol 28 (2) ◽  
pp. 215-222 ◽  
Author(s):  
S.R. Apprich ◽  
M.M. Schreiner ◽  
P. Szomolanyi ◽  
G.H. Welsch ◽  
U.K. Koller ◽  
...  
Keyword(s):  
Predictive Value ◽  
T2 Mapping ◽  
3 Tesla ◽  
Cartilage Defects ◽  
Patellar Cartilage ◽  
3 Tesla Mri

A new MRI grading system for chondromalacia patellae

2016 ◽  
Vol 58 (4) ◽  
pp. 456-463
Author(s):  
Ali Özgen ◽  
Neslihan Taşdelen ◽  
Zeynep Fırat
Keyword(s):  
High Resolution ◽  
Clinical Outcome ◽  
T2 Mapping ◽  
Daily Practice ◽  
Grading System ◽  
Kappa Statistics ◽  
Rater Agreement ◽  
Chondromalacia Patellae ◽  
Cartilage Lesions ◽  
Patellar Cartilage

Background Chondromalacia patellae is a very common disorder. Although magnetic resonance imaging (MRI) is widely used to investigate patellar cartilage lesions, there is no descriptive MRI-based grading system for chondromalacia patellae. Purpose To propose a new MRI grading system for chondromalacia patellae with corresponding high resolution images which might be useful in precisely reporting and comparing knee examinations in routine daily practice and used in predicting natural course and clinical outcome of the patellar cartilage lesions. Material and Methods High resolution fat-saturated proton density (FS PD) images in the axial plane with corresponding T2 mapping images were reviewed. A detailed MRI grading system covering the deficiencies of the existing gradings has been set and presented on these images. Two experienced observers blinded to clinical data examined 44 knee MR images and evaluated patellar cartilage changes according to the proposed grading system. Inter- and intra-rater validity testing using kappa statistics were calculated. Results A descriptive and detailed grading system with corresponding FS PD and T2 mapping images has been presented. Inter-rater agreement was 0.80 (95% confidence interval [CI], 0.71–0.89). Intra-rater agreements were 0.83 (95% CI, 0.74–0.91) for observer A and 0.79 (95% CI, 0.70–0.88) for observer B (k-values). Conclusion We present a new MRI grading system for chondromalacia patellae with corresponding images and good inter- and intra-rater agreement which might be useful in reporting and comparing knee MRI examinations in daily practice and may also have the potential for using more precisely predicting prognosis and clinical outcome of the patients.

scholarly journals Maturation process of regenerated tissues after single-stage simultaneous autologous particulated cartilage implantation and open wedge high tibial osteotomy for articular cartilage defects with medial osteoarthritis of bilateral knees: a case report

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Yasushi Oshima ◽  
Norishige Iizawa ◽  
Shinro Takai ◽  
Tokifumi Majima
Keyword(s):  
T2 Mapping ◽  
Single Stage ◽  
Cartilage Tissue ◽  
Cartilage Defects ◽  
Tibial Osteotomy ◽  
Maturation Process ◽  
Resonance Imaging ◽  
Wedge High Tibial Osteotomy ◽  
Particulated Cartilage ◽  
Articular Cartilage Defects

Abstract Background Open wedge high tibial osteotomy (OWHTO) is an effective treatment option for young and middle-aged active patients with medial unicompartmental knee osteoarthritis (OA). In addition, particulated cartilage implantation has been developed as a simple procedure for cartilage regeneration. Thus, to improve the OWHTO outcomes, a single-stage, simultaneous bilateral knee arthroscopic particulated cartilage implantation with OWHTO was performed. Case presentation A 60-year-old male patient presented with severe bilateral knee pain, with grade 2 varus knee OA of the Kellgren–Lawrence classification. Primary arthroscopic evaluations based on the International Cartilage Repair Society grading system showed grade 3c articular cartilage defects of 1.5 cm in diameter at the center of the bilateral medial femoral condyles. Following bilateral OWHTO, the healthy cartilage tissue was harvested from the lateral wall of the unilateral femoral intercondylar notch and minced with the cartilage processor. Then, subchondral drillings and cartilage fragment implantations into the bilateral defects were performed arthroscopically. One year postsurgery, second-look arthroscopy findings revealed that the defects were filled with cartilage-like tissues. The maturation process of the regenerated tissues was confirmed with T2 mapping magnetic resonance imaging during the 3-year follow-up period. The patient could walk without a cane, and all Knee Injury and Osteoarthritis Outcome Score parameters were improved without any correction loss in 3 years. Conclusions This is the first report to evaluate the maturation process of the implanted particulated cartilage tissue with T2 mapping magnetic resonance imaging for 3 years. The effect of chondral resurfacing procedure with OWHTO remains unclear; however, the implantation of arthroscopic particulated cartilage fragments is a single-stage and less-invasive procedure. This treatment could regenerate cartilage-like tissue in the present case. Therefore, this additional procedure could potentially improve the long-term outcomes of OWHTO.

scholarly journals Quantification of Sodium Relaxation Times and Concentrations as Surrogates of Proteoglycan Content of Patellar CARTILAGE at 3T MRI

Diagnostics ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 2301
Author(s):  
Benedikt Kamp ◽  
Miriam Frenken ◽  
Jan M. Henke ◽  
Daniel B. Abrar ◽  
Armin M. Nagel ◽  
...  
Keyword(s):  
Synovial Fluid ◽  
Healthy Volunteers ◽  
Cartilage Damage ◽  
Relaxation Times ◽  
Cartilage Tissue ◽  
Sodium Mri ◽  
Patellar Cartilage ◽  
Inversion Recovery Pulse ◽  
Damage Data ◽  
The Impact

Sodium MRI has the potential to depict cartilage health accurately, but synovial fluid can influence the estimation of sodium parameters of cartilage. Therefore, this study aimed to reduce the impact of synovial fluid to render the quantitative compositional analyses of cartilage tissue technically more robust. Two dedicated protocols were applied for determining sodium T1 and T2* relaxation times. For each protocol, data were acquired from 10 healthy volunteers and one patient with patellar cartilage damage. Data recorded with multiple repetition times for T1 measurement and multi-echo data acquired with an additional inversion recovery pulse for T2* measurement were analysed using biexponential models to differentiate longitudinal relaxation components of cartilage (T1,car) and synovial fluid (T1,syn), and short (T2s*) from long (T2l*) transversal relaxation components. Sodium relaxation times and concentration estimates in patellar cartilage were successfully determined: T1,car = 14.5 ± 0.7 ms; T1,syn = 37.9 ± 2.9 ms; c(T1-protocol) = 200 ± 48 mmol/L; T2s* = 0.4 ± 0.1 ms; T2l* = 12.6 ± 0.7 ms; c(T2*-protocol) = 215 ± 44 mmol/L for healthy volunteers. In conclusion, a robust determination of sodium relaxation times is possible at a clinical field strength of 3T to quantify sodium concentrations, which might be a valuable tool to determine cartilage health.

Autologous Matrix-Induced Chondrogenesis vs Microfracture with PRP for Chondral Lesions of the Knee in a Rabbit Model

2018 ◽  
Vol 69 (4) ◽  
pp. 894-900 ◽  
Author(s):  
Pal Fodor ◽  
Raluca Fodor ◽  
Arpad Solyom ◽  
Cornel Catoi ◽  
Flaviu Tabaran ◽  
...  
Keyword(s):  
Articular Cartilage ◽  
Cartilage Repair ◽  
Platelet Rich Plasma ◽  
Cartilage Damage ◽  
Rabbit Model ◽  
Cartilage Tissue ◽  
Cartilage Defects ◽  
Full Thickness ◽  
Complete Filling ◽  
Articular Cartilage Damage

Currently, microfracturing is the most commonly used cartilage repair procedure in cartilage defects. Our aim was to study the mechanism of in vivo cartilage repair in case of full-thickness articular cartilage damage of the knee using a three-dimensional matrix implanted without any preseeded cells in the defect. We also investigated whether platelet-rich plasma application after microfracture procedure of the knee is associated with improved outcome compared with traditional microfracture treatment alone in a rabbit model. Histological examination of the chondral defects, revealed the largest amount of new tissue with hyaline-like cartilage features in Hyalofast group. At 12 weeks from implantation of the Hyalofast scaffold demonstrated complete filling of the defect with hyaline cartilage in admixture with the scaffold and bone metaplasia in the deepest areas. In the PRP group, complete filling of the defect with an admixture of fibrous and hyaline-like cartilage tissue appeared with a discreet tendency of endochondral ossification. We confirmed the superiority of the autologous matrix-induced chondrogenesis compared to microfracture and PRP or microfracture alone in case of full-thickness articular cartilage damage of the knee.

scholarly journals Effects of Body Mass Index, Infrapatellar Fat Pad Volume and Age on Patellar Cartilage Defect

2014 ◽  
Vol 2 (11_suppl3) ◽  
pp. 2325967114S0015
Author(s):  
Semra Duran ◽  
Ertugrul Akşahin ◽  
Onur Kocadal ◽  
Cem Nuri Aktekin ◽  
Onur Hapa ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Cartilage Defect ◽  
Cartilage Damage ◽  
Infrapatellar Fat Pad ◽  
Cartilage Defects ◽  
Control Group ◽  
Fat Pad ◽  
Patellar Cartilage ◽  
Causative Factors

Objectives: The aim of this study was to evaluate the associations between patellar cartilage defects and body mass index (BMI), infrapatellar fat pad (IPFP) volume and age. Methods: 100 patients who met the inclusion criteria and were aged 18 to 60, were evaluated retrospectively. The BMI’s of the participants were evaluated according to their weight and height. For detecting and measuring patellar cartilage defects, axial sequences were used and sagittal sequences for were used to evaluate IPFP volumes in MRI. Results: 40 patients were found to have patellar cartilage defects. In this group, age and BMI were higher in both sexes when compared with the controls (P<0.05). The IPFP volume was lower in the group with the patellar cartilage defect when compared with the control group (P<0.05). The IPFP volume was statistically significantly lower in women (P<0.05). Conclusion: Patellar cartilage defects were found to be related to age and BMI. In women, the decrease in IPFP volume seems to be one of the causative factors for patellar cartilage defects. The effect of IPFP volume on articular cartilage in healthy people is unknown. Further studies focusing on patellofemoral cartilage damage are needed to reveal this association.

scholarly journals Radiofrequency chondroplasty is not recommended for the treatment of concomitant grade ii patellar cartilage defects

2020 ◽  
Vol 28 ◽  
pp. S455
Author(s):  
U. Koller ◽  
B. Springer ◽  
C. Rentenberger ◽  
P. Szomolanyi ◽  
W. Waldstein-Wartenberg ◽  
...  
Keyword(s):  
Cartilage Defects ◽  
Patellar Cartilage ◽  
Grade Ii

Cartilage tissue and therapeutic strategies for cartilage repair

2020 ◽  
Vol 20 ◽  
Author(s):  
Sahar Khajeh ◽  
Farzaneh Bozorg-Ghalati ◽  
Mina Zare ◽  
Ghodratollah Panahi ◽  
Vahid Razban
Keyword(s):  
Cartilage Damage ◽  
Trauma Surgery ◽  
Cartilage Regeneration ◽  
Biochemical Properties ◽  
Therapeutic Strategies ◽  
Cartilage Tissue ◽  
Cartilage Defects ◽  
Therapeutic Modalities ◽  
Chondral Defects ◽  
Cell Based Therapy

: High incidence of articular cartilage defects is still a major challenge in orthopedic and trauma surgery worldwide. It has also great socioeconomic effects as it is the major cause of disability in industrialized countries. These highlight the essential need for new treatments. Knowledge about the factors that have been implicated in the pathogenesis of cartilage diseases, including changes in the composition and structure of cartilaginous extracellular matrix (ECM), molecular factors and environmental signaling pathways could help the development of innovative therapeutic strategies. It is consensuses that the success of any technology aiming to repair chondral defects will be dependent upon its ability to produce tissues that most closely replicate the mechanical and biochemical properties of native cartilage. Increasing our knowledge about cartilage tissue and its molecular biomarkers could help us to find new and useful therapeutic approach in cartilage damage. This review tries to describe cartilage tissue biology in detail and discuss different available therapeutic modalities with their pros and cons. New cartilage regeneration strategies and therapies, with focusing on cell-based therapy and tissue engineering, and their underlying molecular and cellular bases will be pointed out as well.

scholarly journals Use of Adult Stem Cells for Cartilage Tissue Engineering: Current Status and Future Developments

2015 ◽  
Vol 2015 ◽  
pp. 1-14 ◽  
Author(s):  
Catherine Baugé ◽  
Karim Boumédiene
Keyword(s):  
Tissue Engineering ◽  
Stem Cells ◽  
Adult Stem Cells ◽  
Current Knowledge ◽  
Cartilage Damage ◽  
Cartilage Tissue Engineering ◽  
Cartilage Tissue ◽  
Current Status ◽  
Cartilage Defects ◽  
Low Oxygen

Due to their low self-repair ability, cartilage defects that result from joint injury, aging, or osteoarthritis, are the most often irreversible and are a major cause of joint pain and chronic disability. So, in recent years, researchers and surgeons have been working hard to elaborate cartilage repair interventions for patients who suffer from cartilage damage. However, current methods do not perfectly restore hyaline cartilage and may lead to the apparition of fibro- or hypertrophic cartilage. In the next years, the development of new strategies using adult stem cells, in scaffolds, with supplementation of culture medium and/or culture in low oxygen tension should improve the quality of neoformed cartilage. Through these solutions, some of the latest technologies start to bring very promising results in repairing cartilage from traumatic injury or chondropathies. This review discusses the current knowledge about the use of adult stem cells in the context of cartilage tissue engineering and presents clinical trials in progress, as well as in the future, especially in the field of bioprinting stem cells.

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