MRI Based Volumetric Assessment of Knee Cartilage after ACL-Reconstruction, Correlated with Qualitative Morphologic Changes in the Joint and with Clinical Outcome. Is there Evidence for Early Posttraumatic Degeneration?

作者：Arnoldi A P^*; Weckbach S; Nus**ickel C; Horng A; Noebauer I; Zysk S; Reiser M; Glaser C

来源：RoFo-Fortschritte auf dem Gebiet der Rontgenstrahlen und der Bildgebenden Verfahren, 2011, 183(12): 1138-1144.

DOI：10.1055/s-0031-1281685

• cartilage
• quantitative MR-imaging
• osteoarthritis

Purpose: The purpose of this study was to analyze potential quantitative and qualitative changes of the knee cartilage and joint indicative of early posttraumatic OA4 years after ACL-reconstruction and to correlate the MRI-findings with the clinical outcome (CO).
Materials and Methods: 1.5 T MRI-scans were performed on 9 patients post-op and 4 years later. Using a high-resolution T1-w-fs-FLASH-3D-sequence cartilage volume (cVol) and thickness (mTh) were quantified. Using standard PD-w fs and T1-w sequences qualitative changes of the joint structures were analyzed based on the WORMS-score. CO was rated by an orthopaedic surgeon using Lysholm-score, OAK-score, Tegneractivity- score (TAS), and Arthrometer KT-1000 testing.
Results: Mean changes of cVol were -1.8% (range: -5.9%; + 0.7%) and of mTh -0.8% (range: -3.0%; + 1.1%). No significant change (95%-CI) could be identified for any compartment. Three patients developed new peripatellar ostheophytes, acute trauma related changes mostly decreased. Mean outcome of Lysholm-score and OAK-score were 90 pts and 86 pts, mean TAS was 4.3 pts. Average maximum tibial translation reached 5.2mm comparing to 6.7mm on the healthy contralateral side.
Conclusion: Despite a tendency towards decreased cVol and mTh 4 years after ACL-reconstruction qMRI revealed no significant cartilage loss. Newly developing osteophytes did not match with the observed good CO. This small pilot study motivates future quantitative and qualitativestructural MRI-based assessment of articular cartilage and other joint structures in order to improve diagnostic tools for the detection of early OA.

• 出版日期2011-12