Assessing acellular scaffold viability with T2-weighted relaxation time value imaging: imaging variables and early clinical associations at 6 months following patellofemoral cartilage repair

Zachariah Gene Wing Ow , Dean Wang , Edmund Jia Xi Zhang , Hamid Rahmatullah Bin Abd Razak , Steven Bak Siew Wong , Jamie Xiu Mei Ho , Keng Lin Wong
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Abstract

This study aims to describe novel magnetic resonance imaging (MRI) imaging characteristics using T2-weighted relaxation time values (T2RVs) for evaluating acellular graft status following cartilage repair, addressing the limitations identified in current imaging techniques. Nine patients (11 lesions) underwent cartilage repair procedures for patellofemoral cartilage lesions. Visual Analog Scales for pain and Tegner scores for function were the primary clinical outcomes measures, with clinical failure defined as nil improvement of either score at follow-up. Radiological outcomes were MRI variables centered around evaluating 2 main domains—graft viability and integration, with individual imaging characteristics being identified based on these 2 domains. At 6 postoperative months, clinical success was observed in 89% (8) of the patients. On average, Visual Analog Scales decreased by 2.6 and Tegner improved by 1.9 points, respectively, with just 1 patient experiencing no pain relief or functional improvement at follow-up. To evaluate the viability and integration of the implanted grafts, several pertinent magnetic resonance variables were utilized, namely T2RV distribution and range, graft surface, matrix and edge characteristics, as well as subchondral bone characteristics. The singular graft failure identified on MRI displayed unique characteristics not identified on the other grafts—that of heterogeneously high T2RV signals within the graft with a discontinuous matrix. T2RV imaging offers a noninvasive method for evaluating cartilage graft viability and integration, potentially improving postoperative monitoring and patient outcomes. Despite promising results, limitations such as sample size and lack of long-term follow-up data need to be addressed in future studies.

用 T2RV 成像评估无细胞支架的活力:髌骨软骨修复术后 6 个月的成像变量和早期临床相关性
本研究旨在利用 T2 加权弛豫时间值(T2RV)描述新型磁共振成像(MRI)成像特征,以评估软骨修复后的无细胞移植状态,解决目前成像技术的局限性。九名患者(11 处病变)因髌骨软骨病变接受了软骨修复手术。疼痛的视觉模拟量表和功能的泰格纳评分是主要的临床结果测量指标,临床失败的定义是在随访中任一评分无改善。放射学结果是核磁共振成像变量,主要评估两个方面--移植物的存活性和整合性,并根据这两个方面确定各自的成像特征。术后 6 个月,89%(8 例)的患者观察到临床成功。平均而言,视觉模拟量表(Visual Analog Scales)下降了 2.6 分,Tegner 改善了 1.9 分,仅有一名患者在随访时疼痛未缓解或功能未改善。为了评估植入移植物的存活能力和整合情况,我们利用了几个相关的磁共振变量,即 T2RV 分布和范围、移植物表面、基质和边缘特征以及软骨下骨特征。在核磁共振成像中发现的单一移植物失败显示了其他移植物未发现的独特特征,即移植物内T2RV信号异质性高,基质不连续。T2RV 成像提供了一种评估软骨移植物存活性和整合性的无创方法,有可能改善术后监测和患者预后。尽管研究结果令人鼓舞,但仍需在今后的研究中解决样本量和缺乏长期随访数据等局限性问题。
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