A practical guide to imaging of cartilage repair with emphasis on bone marrow changes

Orthopedic surgeons have multiple options available to treat articular cartilage lesions, including microfracture, osteochondral autografting, and autologous chondrocyte implantation. By having basic knowledge of these surgical procedures, radiologists can more accurately interpret imaging studies obtained after surgery. In this article, we briefly review the different types of cartilage repair procedures, their appearance on magnetic resonance imaging (MRI), and pathologic MRI findings associated with postoperative complications. We also briefly discuss advanced MRI techniques (T2 mapping, delayed gadolinium-enhanced MRI of cartilage, sodium MRI) that have been recently used to assess the biochemical composition of repair tissue matrix. MRI can accurately assess the status and health of cartilage repair tissue. By providing this information to orthopedic surgeons, radiologists can play a valuable role in the management of patients who undergo cartilage repair surgery.