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

• Published in: European radiology Vol. 24; no. 8; pp. 1758 - 1767
• Main Authors: Tao, Hongyue, Shang, Xiliang, Lu, Rong, Li, Hong, Hua, Yinghui, Feng, Xiaoyuan, Chen, Shuang
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.08.2014; Springer Nature B.V
• Subjects: Adolescent; Adult; Ankle; Ankle Fractures - diagnosis; Ankle Fractures - etiology; Ankle Fractures - surgery; Ankle Joint - pathology; Ankle Joint - surgery; Arthroscopy; Bone marrow; Bone Transplantation - methods; Cartilage; Cartilage, Articular - surgery; Clinical outcomes; Collagen; Diagnostic Radiology; Edema; Female; Follow-Up Studies; Fracture Fixation - methods; Fractures, Spontaneous - diagnosis; Fractures, Spontaneous - etiology; Fractures, Spontaneous - surgery; Humans; Imaging; Internal Medicine; Interventional Radiology; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; Medicine; Medicine & Public Health; Middle Aged; Morphology; Musculoskeletal; Neuroradiology; Orthopedics; Osteochondritis Dissecans - diagnosis; Radiology; Reproducibility of Results; Retrospective Studies; Sports medicine; Transplantation, Autologous; Treatment Outcome; Ultrasound; Young Adult; Ankle; Microfracture; Osteochondritis dissecans (OCD); Bone marrow edema (BME); MRI
• ISSN: 0938-7994; 1432-1084; 1432-1084
• DOI: 10.1007/s00330-014-3196-8

Objectives To quantitatively evaluate cartilage repair after microfracture (MF) for ankle osteochondritis dissecans (OCD) using MRI and analyse correlations between MRI and clinical outcome. Methods Forty-eight patients were recruited and underwent MR imaging, including 3D-DESS, T2-mapping and T2-STIR sequences, and completed American Orthopaedic Foot and Ankle Society (AOFAS) scoring. Thickness index, T2 index of repair tissue (RT) and volume of subchondral bone marrow oedema (BME) were calculated. Subjects were divided into two groups: group A (3–12 months post-op), and group B (12–24 months post-op). Student’s t test was used to compare the MRI and AOFAS score between two groups and Pearson’s correlation coefficient to analyse correlations between them. Results Thickness index and AOFAS score of group B were higher than group A ( P  < 0.001, P  < 0.001). T2 index and BME of group B were lower than group A ( P  < 0.001, P  = 0.012). Thickness index, T2 index and BME were all correlated with AOFAS score ( r  = 0.416, r  = −0.475, r  = −0.353), but BME was correlated with neither thickness index nor T2 index. Conclusions Significant improvement from MF can be expected on the basis of the outcomes of quantitative MRI and AOFAS score. MRI was correlated with AOFAS score. BME is insufficient as an independent predictor to evaluate repair quality, but reduction of BME can improve the patient’s clinical outcome. Key Points • Patients with unstable ankle OCD had satisfactory clinical outcome after MF. • Quantitative MRI correlates with clinical outcome after MF for ankle OCD. • The reduction of subchondral BME will improve the patient’s clinical outcome. • Quantitative MRI can monitor the process of cartilage repair over time.