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Knee Surgery, Sports Traumatology, Arthroscopy

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Open Access 01-01-2009 | Knee

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

Authors: Hiroshi Kuroki, Yasuaki Nakagawa, Koji Mori, Masahiko Kobayashi, Shinichiro Nakamura, Kohei Nishitani, Takaaki Shirai, Takashi Nakamura

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 1/2009

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 (μs), 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. Long-term effect of the osteochondral grafting surgery should be verified in further study.

Adler RS, Dedrick DK, Laing TJ, Chiang EH, Meyer CR, Bland PH, Rubin JM (1992) Quantitative assessment of cartilage surface roughness in osteoarthritis using high frequency ultrasound. Ultrasound Med Biol 18:51–58PubMedCrossRef

Brittberg M, Peterson L (1998) Introduction to an articular cartilage classification. ICRS Newsl 1:8

Brommer H, Laasanen MS, Brama PA, van Weeren PR, Helminen HJ, Jurvelin JS (2006) In situ and ex vivo evaluation of an arthroscopic indentation instrument to estimate the health status of articular cartilage in the equine metacarpophalangeal joint. Vet Surg 35:259–266PubMedCrossRef

Buckwalter JA, Brown TD (2004) Joint injury, repair, and remodeling: roles in post-traumatic osteoarthritis. Clin Orthop Relat Res 423:7–16PubMedCrossRef

Cherin E, Saied A, Laugier P, Netter P, Berger G (1998) Evaluation of acoustical parameter sensitivity to age-related and osteoarthritic changes in articular cartilage using 50-MHz ultrasound. Ultrasound Med Biol 24:341–354PubMedCrossRef

Chiang EH, Adler RS, Meyer CR, Rubin JM, Dedrick DK, Laing TJ (1994) Quantitative assessment of surface roughness using backscattered ultrasound: the effects of finite surface curvature. Ultrasound Med Biol 20:123–135PubMedCrossRef

Chiang EH, Laing TJ, Meyer CR, Boes JL, Rubin JM, Adler RS (1997) Ultrasonic characterization of in vitro osteoarthritic articular cartilage with validation by confocal microscopy. Ultrasound Med Biol 23:205–213PubMedCrossRef

Hangody L, Fules P (2003) Autologous osteochondral mosaicplasty for the treatment of full-thickness defects of weight-bearing joints: ten years of experimental and clinical experience. J Bone Joint Surg Am 85-A(Suppl 2):25–32PubMed

Hangody L, Kish G, Karpati Z, Eberhardt R (1997) Osteochondral plugs: autogenous osteochondral mosaicplasty for the treatment of focal chondral and osteochondral articular defects. Oper Tech Orthop 7:312–322CrossRef

10.

Hangody L, Kish G, Karpati Z, Szerb I, Udvarhelyi I (1997) Arthroscopic autogenous osteochondral mosaicplasty for the treatment of femoral condylar articular defects. A preliminary report. Knee Surg Sports Traumatol Arthrosc 5:262–267PubMedCrossRef

11.

Hattori K, Mori K, Habata T, Takakura Y, Ikeuchi K (2003) Measurement of the mechanical condition of articular cartilage with an ultrasonic probe: quantitative evaluation using wavelet transformation. Clin Biomech (Bristol, Avon) 18:553–557CrossRef

12.

Hattori K, Takakura Y, Morita Y, Takenaka M, Uematsu K, Ikeuchi K (2004) Can ultrasound predict histological findings in regenerated cartilage? Rheumatology (Oxford) 43:302–305CrossRef

13.

Hattori K, Takakura Y, Ohgushi H, Habata T, Uematsu K, Yamauchi J, Yamashita K, Fukuchi T, Sato M, Ikeuchi K (2005) Quantitative ultrasound can assess the regeneration process of tissue-engineered cartilage using a complex between adherent bone marrow cells and a three-dimensional scaffold. Arthritis Res Ther 7:R552–R559PubMedCrossRef

14.

Joiner GA, Bogoch ER, Pritzker KP, Buschmann MD, Chevrier A, Foster FS (2001) High frequency acoustic parameters of human and bovine articular cartilage following experimentally-induced matrix degradation. Ultrason Imaging 23:106–116PubMed

15.

Jurvelin JS, Rasanen T, Kolmonen P, Lyyra T (1995) Comparison of optical, needle probe and ultrasonic techniques for the measurement of articular cartilage thickness. J Biomech 28:231–235PubMedCrossRef

16.

Kim HK, Babyn PS, Harasiewicz KA, Gahunia HK, Pritzker KP, Foster FS (1995) Imaging of immature articular cartilage using ultrasound backscatter microscopy at 50 MHz. J Orthop Res 13:963–970PubMedCrossRef

17.

Kish G, Modis L, Hangody L (1999) Osteochondral mosaicplasty for the treatment of focal chondral and osteochondral lesions of the knee and talus in the athlete. Rationale, indications, techniques, and results. Clin Sports Med 18:45–66PubMedCrossRef

18.

Kuroki H, Nakagawa Y, Mori K, Ikeuchi K, Nakamura T (2004) Mechanical effects of autogenous osteochondral surgical grafting procedures and instrumentation on grafts of articular cartilage. Am J Sports Med 32:612–620PubMedCrossRef

19.

Kuroki H, Nakagawa Y, Mori K, Ohba M, Suzuki T, Mizuno Y, Ando K, Takenaka M, Ikeuchi K, Nakamura T (2004) Acoustic stiffness and change in plug cartilage over time after autologous osteochondral grafting: correlation between ultrasound signal intensity and histological score in a rabbit model. Arthritis Res Ther 6:R492–R504PubMedCrossRef

20.

Kuroki H, Nakagawa Y, Mori K, Kobayashi M, Yasura K, Okamoto Y, Mizuno Y, Ando K, Ikeuchi K, Nakamura T (2006) Maturation-dependent change and regional variations in acoustic stiffness of rabbit articular cartilage: an examination of the superficial collagen-rich zone of cartilage. Osteoarthritis Cartilage 14:784–792PubMedCrossRef

21.

Kuroki H, Nakagawa Y, Mori K, Kobayashi M, Okamoto Y, Yasura K, Nishitani K, Nakamura T (2007) Sequential changes in implanted cartilage after autologous osteochondral transplantation: postoperative acoustic properties up to 1 year in an in vivo rabbit model. Arthroscopy 23:647–654PubMed

22.

Laasanen MS, Toyras J, Vasara AI, Hyttinen MM, Saarakkala S, Hirvonen J, Jurvelin JS, Kiviranta I (2003) Mechano-acoustic diagnosis of cartilage degeneration and repair. J Bone Joint Surg Am 85-A(Suppl 2):78–84PubMed

23.

Lane JG, Tontz WL Jr, Ball ST, Massie JB, Chen AC, Bae WC, Amiel ME, Sah RL, Amiel D (2001) A morphologic, biochemical, and biomechanical assessment of short-term effects of osteochondral autograft plug transfer in an animal model. Arthroscopy 17:856–863PubMed

24.

Lane JG, Massie JB, Ball ST, Amiel ME, Chen AC, Bae WC, Sah RL, Amiel D (2004) Follow-up of osteochondral plug transfers in a goat model: a 6-month study. Am J Sports Med 32:1440–1450PubMedCrossRef

25.

Matsusue Y, Yamamuro T, Hama H (1993) Arthroscopic multiple osteochondral transplantation to the chondral defect in the knee associated with anterior cruciate ligament disruption. Arthroscopy 9:318–321PubMed

26.

Messner K, Maletius W (1996) The long-term prognosis for severe damage to weight-bearing cartilage in the knee: a 14-year clinical and radiographic follow-up in 28 young athletes. Acta Orthop Scand 67:165–168PubMed

27.

Mori K, Hattori K, Habata T, Yamaoka S, Aoki H, Morita Y, Takakura Y, Tomita N, Ikeuchi K (2002) Measurement of the mechanical properties of regenerated articular cartilage using wavelet transformation. In: Ikada Y, Umakoshi Y, Hotta T (eds) Tissue engineering for therapeutic use, 6th edn. Elsevier, Tokyo, pp 133–142

28.

Myers SL, Dines K, Brandt DA, Brandt KD, Albrecht ME (1995) Experimental assessment by high frequency ultrasound of articular cartilage thickness and osteoarthritic changes. J Rheumatol 22:109–116PubMed

29.

Nakagawa Y, Matsusue Y, Ikeda N, Asada Y, Nakamura T (2001) Osteochondral grafting and arthroplasty for end-stage osteochondritis dissecans of the capitellum. A case report and review of the literature. Am J Sports Med 29:650–655PubMed

30.

Nakagawa Y, Matsusue Y, Nakamura T (2003) Osteochondral graft transplantation for steroid-induced osteonecrosis of the femoral condyle. Lancet 362:402PubMedCrossRef

31.

Nakagawa Y, Matsusue Y, Suzuki T, Kuroki H, Nakamura T (2004) Osteochondral grafting for cartilage defects in the patellar grooves of bilateral knee joints. Arthroscopy 20(Suppl 2):32–38PubMedCrossRef

32.

Nakagawa Y, Suzuki T, Kuroki H, Kobayashi M, Okamoto Y, Nakamura T (2007) The effect of surface incongruity of grafted plugs in osteochondral grafting: a report of five cases. Knee Surg Sports Traumatol Arthrosc 15:591–596PubMedCrossRef

33.

Nieminen HJ, Toyras J, Rieppo J, Nieminen MT, Hirvonen J, Korhonen R, Jurvelin JS (2002) Real-time ultrasound analysis of articular cartilage degradation in vitro. Ultrasound Med Biol 28:519–525PubMedCrossRef

34.

Pellaumail B, Watrin A, Loeuille D, Netter P, Berger G, Laugier P, Saied A (2002) Effect of articular cartilage proteoglycan depletion on high frequency ultrasound backscatter. Osteoarthritis Cartilage 10:535–541PubMedCrossRef

35.

Sahlstrom A, Johnell O, Redlund-Johnell I (1997) The natural course of arthrosis of the knee. Clin Orthop Relat Res 340:152–157PubMedCrossRef

36.

Suh JK, Youn I, Fu FH (2001) An in situ calibration of an ultrasound transducer: a potential application for an ultrasonic indentation test of articular cartilage. J Biomech 34:1347–1353PubMedCrossRef

37.

Toyras J, Lyyra-Laitinen T, Niinimaki M, Lindgren R, Nieminen MT, Kiviranta I, Jurvelin JS (2001) Estimation of the Young’s modulus of articular cartilage using an arthroscopic indentation instrument and ultrasonic measurement of tissue thickness. J Biomech 34:251–256PubMedCrossRef

38.

Toyras J, Nieminen HJ, Laasanen MS, Nieminen MT, Korhonen RK, Rieppo J, Hirvonen J, Helminen HJ, Jurvelin JS (2002) Ultrasonic characterization of articular cartilage. Biorheology 39:161–169PubMed

39.

Toyras J, Korhonen RK, Voutilainen T, Jurvelin JS, Lappalainen R (2005) Improvement of arthroscopic cartilage stiffness probe using amorphous diamond coating. J Biomed Mater Res B Appl Biomater 73:15–22PubMed

Title: Ultrasound properties of articular cartilage immediately after osteochondral grafting surgery: in cases of traumatic cartilage lesions and osteonecrosis
Authors: Hiroshi Kuroki
Yasuaki Nakagawa
Koji Mori
Masahiko Kobayashi
Shinichiro Nakamura
Kohei Nishitani
Takaaki Shirai
Takashi Nakamura
Publication date: 01-01-2009
Publisher: Springer-Verlag
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 1/2009
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-008-0586-y

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

Abstract

Keynote webinar | Spotlight on medication adherence

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Abstract

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