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Published on: May 21, 2013
Indirect MR-arthrography in osteochondral autograft and crushed bone graft with a collagen membrane--correlation with
F Streitparth1, P Schöttle, H Schell
1Klinik für Strahlenheilkunde, Charité, Campus Virchow-Klinikum, Humboldt-University, Berlin, Germany. florian.streitparth@charite.de
Objective:
To analyze the spectrum of findings in indirect MR-arthrography following osteochondral autograft transfer system (OATS) and crushed bone graft using a magnetic resonance imaging (MRI) scoring and grading system in relation to histology as the standard of reference.
Materials And Methods:
Iatrogenic lesions were set at ovine condylar facets (n=6/group), treated with OATS or crushed bone graft. 1.5 T MRI was performed 6 months after surgery using PD-weighted (w fat saturated (fs) fast spin echo (FSE), T1-w 2D, and 3D fs gradient echo (GE) sequences 30 min. after i.v. Gd-DTPA administration and passive joint exercise. The repair tissue was evaluated by two independent radiologists. The MR findings were compared to histology.
Results:
In all cases, MRI and histologic grading correlated well and showed significant superior repair in OATS at 6 months (p<0.05), reproducing the original articular contour and a good subchondral restoration. FsT1-w3DGE proved most appropriate identifying characteristic post-operative findings: the OATS group demonstrated bone marrow edema at the donor site and the graft/host interface showed significant enhancement in indirect MR-arthrography, indicating fibrocartilage. After crushed bone graft, we found an irregular structure and significant contrast uptake, consistent with remnants of bone grafts surrounded by inflammatory tissue.
Conclusion:
Indirect MR-arthrography is an accurate, non-invasive monitoring tool following OATS and crushed bone graft as the MRI scoring and grading system allows a reliable evaluation of normal and pathological osteochondral repair with a high histologic correlation.
Insights
Indirect MR-arthrography accurately assesses osteochondral repair after osteochondral autograft transfer system (OATS) and crushed bone graft. MRI scoring correlates well with histology, showing superior OATS repair at six months.
Area of Science:
- Orthopedics
- Radiology
- Regenerative Medicine
Background:
- Osteochondral defects require effective repair strategies.
- Osteochondral autograft transfer system (OATS) and crushed bone graft are surgical options.
- Non-invasive imaging is crucial for monitoring repair outcomes.
Purpose of the Study:
- To evaluate indirect MR-arthrography findings after OATS and crushed bone graft.
- To correlate magnetic resonance imaging (MRI) scores with histological data.
- To assess the efficacy of a scoring and grading system for osteochondral repair.
Main Methods:
- Iatrogenic ovine condylar lesions were treated with OATS or crushed bone graft.
- 1.5 T MRI was performed six months post-surgery using various sequences after contrast administration.
- Two radiologists evaluated MR findings, compared with histology.
Main Results:
- MRI and histological grading showed good correlation, with superior repair in OATS (p<0.05).
- FsT1-w3DGE sequences identified OATS-related bone marrow edema and graft enhancement.
- Crushed bone graft showed irregular structure and inflammatory tissue uptake.
Conclusions:
- Indirect MR-arthrography is accurate for monitoring OATS and crushed bone graft.
- The MRI scoring and grading system reliably evaluates osteochondral repair.
- High correlation with histology validates the non-invasive monitoring approach.
