Skip to main content
Top
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 6/2014

01-06-2014 | Knee

In vivo evaluation of biomechanical properties in the patellofemoral joint after matrix-associated autologous chondrocyte transplantation by means of quantitative T2 MRI

Authors: M. L. Pachowsky, S. Trattnig, B. Wondrasch, S. Apprich, S. Marlovits, A. Mauerer, Goetz H. Welsch, M. Blanke

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 6/2014

Login to get access

Abstract

Purpose

To determine in vivo biomechanical properties of articular cartilage and cartilage repair tissue of the patella, using biochemical MRI by means of quantitative T2 mapping.

Methods

Twenty MR scans were achieved at 3T MRI, using a new 8-channel multi-function coil allowing controlled bending of the knee. Multi-echo spin-echo T2 mapping was prepared in healthy volunteers and in age- and sex-matched patients after matrix-associated autologous chondrocyte transplantation (MACT) of the patella. MRI was performed at 0° and 45° of flexion of the knee after 0 min and after 1 h. A semi-automatic region-of-interest analysis was performed for the whole patella cartilage. To allow stratification with regard to the anatomical (collagen) structure, further subregional analysis was carried out (deep–middle–superficial cartilage layer). Statistical analysis of variance was performed.

Results

During 0° flexion (decompression), full-thickness T2 values showed no significant difference between volunteers (43 ms) and patients (41 ms). Stratification was more pronounced for healthy cartilage compared to cartilage repair tissue. During 45° flexion (compression), full-thickness T2 values within volunteers were significantly increased (54 ms) compared to patients (44 ms) (p < 0.001). Again, stratification was more pronounced in volunteers compared to patients. The volunteer group showed no significant increase in T2 values measured in straight position and in bended position. There was no significant difference between the 0- and the 60-min MRI examination. T2 values in the patient group increased between the 0- and the 60-min examination. However, the increase was only significant in the superior cartilage layer of the straight position (p = 0.021).

Conclusion

During compression (at 45° flexion), healthy patellar cartilage showed a significant increase in T2-values, indicating adaptations of water content and collagen fibril orientation to mechanical load. This could not be observed within the patella cartilage after cartilage repair (MACT) of the patella, most obvious due to a lack of biomechanical adjustment.

Level of evidence

III.
Literature
1.
go back to reference Alparslan L, Winalski CS, Boutin RD et al (2001) Postoperative magnetic resonance imaging of articular cartilage repair. Semin Musculoskelet Radiol 5(4):345–363PubMedCrossRef Alparslan L, Winalski CS, Boutin RD et al (2001) Postoperative magnetic resonance imaging of articular cartilage repair. Semin Musculoskelet Radiol 5(4):345–363PubMedCrossRef
2.
go back to reference Apprich S, Mamisch TC, Welsch GH et al (2011) Quantitative T2 mapping of the patella at 3.0T is sensitive to early cartilage degeneration, but also to loading of the knee. Eur J Radiol 81(4):e438–e443PubMedCrossRef Apprich S, Mamisch TC, Welsch GH et al (2011) Quantitative T2 mapping of the patella at 3.0T is sensitive to early cartilage degeneration, but also to loading of the knee. Eur J Radiol 81(4):e438–e443PubMedCrossRef
3.
go back to reference Battaglia M, Vannini F, Buda R et al (2011) Arthroscopic autologous chondrocyte implantation in osteochondral lesions of the talus: mid-term T2-mapping MRI evaluation. Knee Surg Sports Traumatol Arthrosc 19(8):1376–1384PubMedCrossRef Battaglia M, Vannini F, Buda R et al (2011) Arthroscopic autologous chondrocyte implantation in osteochondral lesions of the talus: mid-term T2-mapping MRI evaluation. Knee Surg Sports Traumatol Arthrosc 19(8):1376–1384PubMedCrossRef
4.
go back to reference Brittberg M, Faxen E, Peterson L (1994) Carbon fiber scaffolds in the treatment of early knee osteoarthritis. A prospective 4-year followup of 37 patients. Clin Orthop Relat Res 307:155–164PubMed Brittberg M, Faxen E, Peterson L (1994) Carbon fiber scaffolds in the treatment of early knee osteoarthritis. A prospective 4-year followup of 37 patients. Clin Orthop Relat Res 307:155–164PubMed
5.
go back to reference Brittberg M, Lindahl A, Nilsson A et al (1994) Treatment of deep cartilage defects in the knee with autologous chondrocyte transplantation. N Engl J Med 331(14):889–895PubMedCrossRef Brittberg M, Lindahl A, Nilsson A et al (1994) Treatment of deep cartilage defects in the knee with autologous chondrocyte transplantation. N Engl J Med 331(14):889–895PubMedCrossRef
6.
go back to reference Bydder M, Rahal A, Fullerton GD et al (2007) The magic angle effect: a source of artifact, determinant of image contrast, and technique for imaging. J Magn Reson Imaging 25(2):290–300PubMedCrossRef Bydder M, Rahal A, Fullerton GD et al (2007) The magic angle effect: a source of artifact, determinant of image contrast, and technique for imaging. J Magn Reson Imaging 25(2):290–300PubMedCrossRef
7.
go back to reference Chung CB, Frank LR, Resnick D (2001) Cartilage imaging techniques: current clinical applications and state of the art imaging. Clin Orthop Relat Res 391(Suppl):S370–S378PubMedCrossRef Chung CB, Frank LR, Resnick D (2001) Cartilage imaging techniques: current clinical applications and state of the art imaging. Clin Orthop Relat Res 391(Suppl):S370–S378PubMedCrossRef
8.
go back to reference D’Anchise R, Manta N, Prospero E et al (2005) Autologous implantation of chondrocytes on a solid collagen scaffold: clinical and histological outcomes after two years of follow-up. J Orthopaed Traumatol 6:36–43CrossRef D’Anchise R, Manta N, Prospero E et al (2005) Autologous implantation of chondrocytes on a solid collagen scaffold: clinical and histological outcomes after two years of follow-up. J Orthopaed Traumatol 6:36–43CrossRef
9.
go back to reference Eckstein F, Lemberger B, Gratzke C et al (2005) In vivo cartilage deformation after different types of activity and its dependence on physical training status. Ann Rheum Dis 64(2):291–295PubMedCentralPubMedCrossRef Eckstein F, Lemberger B, Gratzke C et al (2005) In vivo cartilage deformation after different types of activity and its dependence on physical training status. Ann Rheum Dis 64(2):291–295PubMedCentralPubMedCrossRef
10.
go back to reference Felson DT (2004) Risk factors for osteoarthritis: understanding joint vulnerability. Clin Orthop Relat Res 427(Suppl):S16–S21PubMedCrossRef Felson DT (2004) Risk factors for osteoarthritis: understanding joint vulnerability. Clin Orthop Relat Res 427(Suppl):S16–S21PubMedCrossRef
11.
go back to reference Goodwin DW, Zhu H, Dunn JF (2000) In vitro MR imaging of hyaline cartilage: correlation with scanning electron microscopy. Am J Roentgenol (AJR) 174(2):405–409CrossRef Goodwin DW, Zhu H, Dunn JF (2000) In vitro MR imaging of hyaline cartilage: correlation with scanning electron microscopy. Am J Roentgenol (AJR) 174(2):405–409CrossRef
12.
go back to reference Huberti HH, Hayes WC (1984) Patellofemoral contact pressures. The influence of q-angle and tendofemoral contact. J Bone Joint Surg Am 66(5):715–724PubMed Huberti HH, Hayes WC (1984) Patellofemoral contact pressures. The influence of q-angle and tendofemoral contact. J Bone Joint Surg Am 66(5):715–724PubMed
13.
go back to reference Jones CW, Willers C, Keogh A et al (2008) Matrix-induced autologous chondrocyte implantation in sheep: objective assessments including confocal arthroscopy. J Orthop Res 26(3):292–303PubMedCrossRef Jones CW, Willers C, Keogh A et al (2008) Matrix-induced autologous chondrocyte implantation in sheep: objective assessments including confocal arthroscopy. J Orthop Res 26(3):292–303PubMedCrossRef
14.
go back to reference Kocher MS, Steadman JR, Briggs KK et al (2004) Reliability, validity, and responsiveness of the Lysholm knee scale for various chondral disorders of the knee. J Bone Joint Surg Am 86-A(6):1139–1145PubMed Kocher MS, Steadman JR, Briggs KK et al (2004) Reliability, validity, and responsiveness of the Lysholm knee scale for various chondral disorders of the knee. J Bone Joint Surg Am 86-A(6):1139–1145PubMed
15.
go back to reference Liess C, Lusse S, Karger N et al (2002) Detection of changes in cartilage water content using MRI T2-mapping in vivo. Osteoarthr Cartil 10(12):907–913PubMedCrossRef Liess C, Lusse S, Karger N et al (2002) Detection of changes in cartilage water content using MRI T2-mapping in vivo. Osteoarthr Cartil 10(12):907–913PubMedCrossRef
16.
go back to reference Madry H, van Dijk CN, Mueller-Gerbl M (2010) The basic science of the subchondral bone. Knee Surg Sports Traumatol Arthrosc 18(4):419–433PubMedCrossRef Madry H, van Dijk CN, Mueller-Gerbl M (2010) The basic science of the subchondral bone. Knee Surg Sports Traumatol Arthrosc 18(4):419–433PubMedCrossRef
17.
go back to reference Mamisch TC, Trattnig S, Quirbach S et al (2010) Quantitative T2 mapping of knee cartilage: differentiation of healthy control cartilage and cartilage repair tissue in the knee with unloading—initial results. Radiology 254(3):818–826PubMedCrossRef Mamisch TC, Trattnig S, Quirbach S et al (2010) Quantitative T2 mapping of knee cartilage: differentiation of healthy control cartilage and cartilage repair tissue in the knee with unloading—initial results. Radiology 254(3):818–826PubMedCrossRef
18.
go back to reference Marcacci M, Berruto M, Brocchetta D et al (2005) Articular cartilage engineering with Hyalograft C: 3-year clinical results. Clin Orthop Relat Res 435:96–105PubMedCrossRef Marcacci M, Berruto M, Brocchetta D et al (2005) Articular cartilage engineering with Hyalograft C: 3-year clinical results. Clin Orthop Relat Res 435:96–105PubMedCrossRef
19.
go back to reference Marlovits S, Kutscha-Lissberg F, Aldrian S et al (2004) Autologous chondrocyte transplantation for the treatment of articular cartilage defects in the knee joint. Techniques and results. Radiologe 44(8):763–772PubMedCrossRef Marlovits S, Kutscha-Lissberg F, Aldrian S et al (2004) Autologous chondrocyte transplantation for the treatment of articular cartilage defects in the knee joint. Techniques and results. Radiologe 44(8):763–772PubMedCrossRef
21.
go back to reference Mosher TJ, Dardzinski BJ, Smith MB (2000) Human articular cartilage: influence of aging and early symptomatic degeneration on the spatial variation of T2-preliminary findings at 3 T. Radiology 214(1):259–266PubMedCrossRef Mosher TJ, Dardzinski BJ, Smith MB (2000) Human articular cartilage: influence of aging and early symptomatic degeneration on the spatial variation of T2-preliminary findings at 3 T. Radiology 214(1):259–266PubMedCrossRef
22.
go back to reference Mosher TJ, Smith HE, Collins C et al (2005) Change in knee cartilage T2 at MR imaging after running: a feasibility study. Radiology 234(1):245–249PubMedCrossRef Mosher TJ, Smith HE, Collins C et al (2005) Change in knee cartilage T2 at MR imaging after running: a feasibility study. Radiology 234(1):245–249PubMedCrossRef
23.
go back to reference Poole AR, Kojima T, Yasuda T et al (2001) Composition and structure of articular cartilage: a template for tissue repair. Clin Orthop Relat Res 391(Suppl):S26–S33PubMedCrossRef Poole AR, Kojima T, Yasuda T et al (2001) Composition and structure of articular cartilage: a template for tissue repair. Clin Orthop Relat Res 391(Suppl):S26–S33PubMedCrossRef
24.
go back to reference Recht M, White LM, Winalski CS et al (2003) MR imaging of cartilage repair procedures. Skeletal Radiol 32(4):185–200PubMedCrossRef Recht M, White LM, Winalski CS et al (2003) MR imaging of cartilage repair procedures. Skeletal Radiol 32(4):185–200PubMedCrossRef
25.
go back to reference Rubenstein JD, Kim JK, Henkelman RM (1996) Effects of compression and recovery on bovine articular cartilage: appearance on MR images. Radiology 201(3):843–850PubMed Rubenstein JD, Kim JK, Henkelman RM (1996) Effects of compression and recovery on bovine articular cartilage: appearance on MR images. Radiology 201(3):843–850PubMed
26.
go back to reference Salsich GB, Ward SR, Terk MR et al (2003) In vivo assessment of patellofemoral joint contact area in individuals who are pain free. Clin Orthop Relat Res 417:277–284PubMed Salsich GB, Ward SR, Terk MR et al (2003) In vivo assessment of patellofemoral joint contact area in individuals who are pain free. Clin Orthop Relat Res 417:277–284PubMed
27.
go back to reference Shiomi T, Nishii T, Myoui A et al (2010) Influence of knee positions on T2, T*2, and dGEMRIC mapping in porcine knee cartilage. Magn Reson Med 64(3):707–714PubMedCrossRef Shiomi T, Nishii T, Myoui A et al (2010) Influence of knee positions on T2, T*2, and dGEMRIC mapping in porcine knee cartilage. Magn Reson Med 64(3):707–714PubMedCrossRef
28.
go back to reference Smith HE, Mosher TJ, Dardzinski BJ et al (2001) Spatial variation in cartilage T2 of the knee. J Magn Reson Imaging 14(1):50–55PubMedCrossRef Smith HE, Mosher TJ, Dardzinski BJ et al (2001) Spatial variation in cartilage T2 of the knee. J Magn Reson Imaging 14(1):50–55PubMedCrossRef
29.
go back to reference Tegner Y, Lysholm J (1985) Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res 198:43–49PubMed Tegner Y, Lysholm J (1985) Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res 198:43–49PubMed
30.
go back to reference Trattnig S, Ba-Ssalamah A, Pinker K et al (2005) Matrix-based autologous chondrocyte implantation for cartilage repair: noninvasive monitoring by high-resolution magnetic resonance imaging. Magn Reson Imaging 23(7):779–787PubMedCrossRef Trattnig S, Ba-Ssalamah A, Pinker K et al (2005) Matrix-based autologous chondrocyte implantation for cartilage repair: noninvasive monitoring by high-resolution magnetic resonance imaging. Magn Reson Imaging 23(7):779–787PubMedCrossRef
31.
go back to reference Watrin-Pinzano A, Ruaud JP, Cheli Y et al (2004) Evaluation of cartilage repair tissue after biomaterial implantation in rat patella by using T2 mapping. MAGMA 17(3–6):219–228PubMedCrossRef Watrin-Pinzano A, Ruaud JP, Cheli Y et al (2004) Evaluation of cartilage repair tissue after biomaterial implantation in rat patella by using T2 mapping. MAGMA 17(3–6):219–228PubMedCrossRef
32.
go back to reference Welsch GH, Mamisch TC, Domayer SE et al (2008) Cartilage T2 assessment at 3-T MR imaging: in vivo differentiation of normal hyaline cartilage from reparative tissue after two cartilage repair procedures—initial experience. Radiology 247(1):154–161PubMedCrossRef Welsch GH, Mamisch TC, Domayer SE et al (2008) Cartilage T2 assessment at 3-T MR imaging: in vivo differentiation of normal hyaline cartilage from reparative tissue after two cartilage repair procedures—initial experience. Radiology 247(1):154–161PubMedCrossRef
33.
go back to reference Welsch GH, Mamisch TC, Zak L et al (2010) Evaluation of cartilage repair tissue after matrix-associated autologous chondrocyte transplantation using a hyaluronic-based or a collagen-based scaffold with morphological MOCART scoring and biochemical T2 mapping: preliminary results. Am J Sports Med 38(5):934–942PubMedCrossRef Welsch GH, Mamisch TC, Zak L et al (2010) Evaluation of cartilage repair tissue after matrix-associated autologous chondrocyte transplantation using a hyaluronic-based or a collagen-based scaffold with morphological MOCART scoring and biochemical T2 mapping: preliminary results. Am J Sports Med 38(5):934–942PubMedCrossRef
34.
go back to reference White LM, Sussman MS, Hurtig M et al (2006) Cartilage T2 assessment: differentiation of normal hyaline cartilage and reparative tissue after arthroscopic cartilage repair in equine subjects. Radiology 241(2):407–414PubMedCrossRef White LM, Sussman MS, Hurtig M et al (2006) Cartilage T2 assessment: differentiation of normal hyaline cartilage and reparative tissue after arthroscopic cartilage repair in equine subjects. Radiology 241(2):407–414PubMedCrossRef
Metadata
Title
In vivo evaluation of biomechanical properties in the patellofemoral joint after matrix-associated autologous chondrocyte transplantation by means of quantitative T2 MRI
Authors
M. L. Pachowsky
S. Trattnig
B. Wondrasch
S. Apprich
S. Marlovits
A. Mauerer
Goetz H. Welsch
M. Blanke
Publication date
01-06-2014
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 6/2014
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-013-2527-7

Other articles of this Issue 6/2014

Knee Surgery, Sports Traumatology, Arthroscopy 6/2014 Go to the issue