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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 7/2018

01-07-2018 | Ankle

CT arthrography visualizes tissue growth of osteochondral defects of the talus after microfracture

Authors: Hong-Geun Jung, Na-Ra Kim, Ji-Young Jeon, Dong-Oh Lee, Jun-Sang Eom, Jong-Soo Lee, Sung-Wook Kim

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 7/2018

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Abstract

Purpose

Little is known about the arthroscopic or radiographic outcomes after arthroscopic microfracture of osteochondral lesions of the talus (OLTs). The purpose of this study was to investigate tissue growth after arthroscopic microfracture of OLTs using computed tomography arthrography (CTA) and to identify the relationship between CTA findings and clinical outcomes. We hypothesized that the morphology of the repaired tissue would be similar to that of normal anatomy and correlate with the clinical outcomes.

Methods

Forty-two ankles treated using arthroscopic microfracture of OLTs between 2009 and 2014 were monitored. CTA was performed post-operatively at 6 months and at 1 and 2 years after surgery. The post-operative thickness of the repaired tissue associated with OLT (grade) and the volume of the subchondral cystic lesions were evaluated using CTA. Clinical outcomes, including the pain visual analog scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) ankle functional scores, were evaluated and correlated with CTA.

Results

The proportion of fully grown tissue (grade 3) increased over time; specifically, the rates were 12/40 (33.3%) at 6 months, 11/18 (61.1%) at 1 year, and 8/10 (80%) at 2 years after surgery (p = 0.005). The VAS pain (p < 0.001) and AOFAS scores (p < 0.001) were also improved at the final follow-up; however, they were not associated with repaired tissue thickness as shown by CTA (n.s.).

Conclusions

After microfracture of OLTs, tissue growth in the osteochondral defects was well visualized using CT arthrography and was observed in most cases. However, the CTA findings were not related to the clinical outcomes.

Level of evidence

IV.
Literature
1.
2.
Choi BH, Kim NR, Moon SG, Park JY, Choi JW (2015) Superior labral cleft after superior labral anterior-to-posterior tear repair: CT arthrographic features and correlation with clinical outcome. Radiology 278:441–448CrossRefPubMed
3.
Choi WJ, Park KK, Kim BS, Lee JW (2009) Osteochondral lesion of the talus: is there a critical defect size for poor outcome? Am J Sports Med 37:1974–1980CrossRefPubMed
4.
Cochet H, Pele E, Amoretti N, Brunot S, Lafenetre O, Hauger O (2010) Anterolateral ankle impingement: diagnostic performance of MDCT arthrography and sonography. AJR Am J Roentgenol 194:1575–1580CrossRefPubMed
5.
De Filippo M, Bertellini A, Pogliacomi F, Sverzellati N, Corradi D, Garlaschi G, Zompatori M (2009) Multidetector computed tomography arthrography of the knee: diagnostic accuracy and indications. Eur J Radiol 70:342–351CrossRefPubMed
6.
De Filippo M, Pogliacomi F, Bertellini A, Araoz PA, Averna R, Sverzellati N, Ingegnoli A, Corradi M, Costantino C, Zompatori M (2010) MDCT arthrography of the wrist: diagnostic accuracy and indications. Eur J Radiol 74:221–225CrossRefPubMed
7.
Elias I, Jung JW, Raikin SM, Schweitzer MW, Carrino JA, Morrison WB (2006) Osteochondral lesions of the talus: change in MRI findings over time in talar lesions without operative intervention and implications for staging systems. Foot Ankle Int 27:157–166CrossRefPubMed
8.
Giannini S, Battaglia M, Buda R, Cavallo M, Ruffilli A, Vannini F (2009) Surgical treatment of osteochondral lesions of the talus by open-field autologous chondrocyte implantation: a 10-year follow-up clinical and magnetic resonance imaging T2-mapping evaluation. Am J Sports Med 37:112S–118SCrossRefPubMed
9.
Giannini S, Buda R, Ruffilli A, Cavallo M, Pagliazzi G, Bulzamini MC, Desando G, Luciani D, Vannini F (2014) Arthroscopic autologous chondrocyte implantation in the ankle joint. Knee Surg Sports Traumatol Arthrosc 22:1311–1319CrossRefPubMed
10.
Gobbi A, Francisco RA, Lubowitz JH, Allegra F, Canata G (2006) Osteochondral lesions of the talus: randomized controlled trial comparing chondroplasty, microfracture, and osteochondral autograft transplantation. Arthroscopy 22:1085–1092CrossRefPubMed
11.
Hannon CP, Smyth NA, Murawski CD, Savage-Elliott I, Deyer TW, Calder JD, Kennedy JG (2014) Osteochondral lesions of the talus: aspects of current management. Bone Joint J 96:164–171CrossRefPubMed
12.
Hepple S, Winson IG, Glew D (1999) Osteochondral lesions of the talus: a revised classification. Foot Ankle Int 20:789–793CrossRefPubMed
13.
Higashiyama I, Kumai T, Takakura Y, Tamail S (2000) Follow-up study of MRI for osteochondral lesion of the talus. Foot Ankle Int 21:127–133CrossRefPubMed
14.
Kim YS, Park EH, Koh YG, Lee JW (2014) Supramalleolar osteotomy with bone marrow stimulation for varus ankle osteoarthritis: clinical results and second-look arthroscopic evaluation. Am J Sports Med 42:1558–1566CrossRefPubMed
15.
Kitaoka HB, Alexander IJ, Adelaar RS, Nunley JA, Myerson MS, Sanders M (1994) Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int 15:349–353CrossRefPubMed
16.
Kraniotis P, Maragkos S, Tyllianakis M, Petsas T, Karantanas AH (2012) Ankle post-traumatic osteoarthritis: a CT arthrography study in patients with bi-and trimalleolar fractures. Skeletal Radiol 41:803–809CrossRefPubMed
17.
Kuni B, Schmitt H, Chloridis D, Ludwig K (2012) Clinical and MRI results after microfracture of osteochondral lesions of the talus. Arch Orthop Trauma Surg 132:1765–1771CrossRefPubMed
18.
Lee KB, Bai LB, Chung JY, Seon JK (2010) Arthroscopic microfracture for osteochondral lesions of the talus. Knee Surg Sports Traumatol Arthrosc 18:247–253CrossRefPubMed
19.
Mintz DN, Tashjian GS, Connell DA, Deland JT, O’Malley M, Potter HG (2003) Osteochondral lesions of the talus: a new magnetic resonance grading system with arthroscopic correlation. Arthroscopy 19:353–359CrossRefPubMed
20.
Nakaura T, Nakamura S, Maruyama N, Funama Y, Awai K, Harada K, Uemura S, Yamashita Y (2012) Low contrast agent and radiation dose protocol for hepatic dynamic CT of thin adults at 256-detector row CT: effect of low tube voltage and hybrid iterative reconstruction algorithm on image quality. Radiology 264:445–454CrossRefPubMed
21.
Nishii T, Tanaka H, Nakanishi K, Sugano N, Miki H, Yoshikawa H (2005) Fat-suppressed 3D spoiled gradient-echo MRI and MDCT arthrography of articular cartilage in patients with hip dysplasia. Am J Roentgenol 185:379–385CrossRef
22.
Omoumi P, Michoux N, Thienpont E, Roemer FW, Vande Berg BC (2015) Anatomical distribution of areas of preserved cartilage in advanced femorotibial osteoarthritis using CT arthrography (part 1). Osteoarthritis Cartilage 23:83–87CrossRefPubMed
23.
Park HW, Lee KB (2015) Comparison of chondral versus osteochondral lesions of the talus after arthroscopic microfracture. Knee Surg Sports Traumatol Arthrosc 23:860–867CrossRefPubMed
24.
Reiser M, Karpf PM, Bernett P (1982) Diagnosis of chondromalacia patellae using CT arthrography. Eur J Radiol 2:181–186PubMed
25.
Ross KA, Hannon CP, Deyer TW, Smyth NA, Hogan M, Do HT, Kennedy JG (2014) Functional and MRI outcomes after arthroscopic microfracture for treatment of osteochondral lesions of the distal tibial plafond. J Bone Joint Surg Am 96:1708–1715CrossRefPubMed
26.
Schmid MR, Pfirrmann CW, Hodler J, Vienne P, Zanetti M (2003) Cartilage lesions in the ankle joint: comparison of MR arthrography and CT arthrography. Skeletal Radiol 32:259–265CrossRefPubMed
27.
Schreiber JJ, Anderson PA, Rosas HG, Buchholz AL, Au AG (2011) Hounsfield units for assessing bone mineral density and strength: a tool for osteoporosis management. J Bone Joint Surg Am 93:1057–1063CrossRefPubMed
28.
Tan TC, Wilcox DM, Frank L, Shih C, Trudell DJ, Sartoris DJ, Resnick D (1996) MR imaging of articular cartilage in the ankle: comparison of available imaging sequences and methods of measurement in cadavers. Skeletal Radiol 25:749–755CrossRefPubMed
29.
Tao H, Shang X, Lu R, Li H, Hua Y, Feng X, Chen S (2014) Quantitative magnetic resonance imaging (MRI) evaluation of cartilage repair after microfracture (MF) treatment for adult unstable osteochondritis dissecans (OCD) in the ankle: correlations with clinical outcome. Eur Radiol 24:1758–1767CrossRefPubMed
30.
Thienpont E, Schwab PE, Omoumi P (2014) Wear patterns in anteromedial osteoarthritis of the knee evaluated with CT-arthrography. Knee 21:S15–S19CrossRefPubMed
31.
van Dijk CN, Reilingh ML, Zengerink M, van Bergen CJ (2010) Osteochondral defects in the ankle: why painful? Knee Surg Sports Traumatol Arthrosc 18:570–580CrossRefPubMedPubMedCentral
32.
Vande Berg BC, Lecouvet FE, Poilvache P, Jamart J, Materne R, Lengele B, Maldague B, Malghem J (2002) Assessment of knee cartilage in cadavers with dual-detector spiral CT arthrography and MR imaging. Radiology 222:430–436CrossRefPubMed
Metadata
Title
CT arthrography visualizes tissue growth of osteochondral defects of the talus after microfracture
Authors
Hong-Geun Jung
Na-Ra Kim
Ji-Young Jeon
Dong-Oh Lee
Jun-Sang Eom
Jong-Soo Lee
Sung-Wook Kim
Publication date
01-07-2018
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 7/2018
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-017-4610-y

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