Etiology of Cartilage Lesions Does Not Affect Clinical Outcomes of Patellofemoral Autologous Chondrocyte Implantation.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. 17. Cartilage. 2018 Jan;9(1):21-29. doi: 10.1177/1947603516681131. Epub 2016 Dec 1. Correlation of MRI Appearance of Autologous Chondrocyte Implantation in the Ankle with Clinical Outcome. Chan KW(1), Ferkel RD(2), Kern B(3), Chan SS(4), Applegate GR(5). Author information: (1)1 California Orthopedic & Sports Medicine, San Francisco, CA, USA. (2)2 Southern California Orthopedic Institute, Van Nuys, CA, USA. (3)3 The Orthopaedic Institute, Paducah, KY, USA. (4)4 Zwanger-Pesiri Radiology, Lindenhurst, NY, USA. (5)5 Pacific Advanced Radiology, Van Nuys, CA, USA. The objective of this study was to characterize magnetic resonance imaging (MRI) findings and correlate with clinical results in patients who underwent autologous chondrocyte implantation (ACI) of osteochondral lesions of the talus (OLT). METHODS: Twenty-four grafts were evaluated at a mean 65.8 months after ACI for OLT. MRI was performed on a 1.5-T GE scanner using multiple sequences. Graft appearance was compared with preoperative MRI and evaluated for 6 criteria: defect fill, surface regularity, signal pattern, bone marrow edema, subchondral plate irregularity, and presence of cystic lesions. Clinical outcome was measured with the American Orthopaedic Foot and Ankle Society (AOFAS) clinical outcome score. RESULTS: Of 24 grafts, 22 (92%) demonstrated >75% defect fill. Eighteen (75%) had a mildly irregular and 6 (25%) had a moderately irregular articular surface. The signal pattern of the repair tissue was heterogenous in 23 (96%); 14 (58%) layered and 9 (38%) mottled. Fourteen grafts (58%) showed decreased amount of bone marrow edema while 4 (17%) had no change and 5 (21%) had an increase in the amount of bone marrow edema. The subchondral bone plate was abnormal in most grafts, with focal defects seen in 10, slight depression in 7, and both in 5. Seven had an increase in cystic lesions while the others had no change, decrease or no cysts seen. Mean postoperative AOFAS score was 87.5 with mean improvement of 39.4. CONCLUSIONS: At 66-month mean follow-up, MRI appearance of the ACI grafts show imaging abnormalities but demonstrate good clinical results. While MRI is an important tool in the postoperative assessment of ACI grafts, the various variations from a normal/nonoperative ankle must be interpreted with caution. DOI: 10.1177/1947603516681131 PMCID: PMC5724669