Date of Presentation
5-4-2023 12:00 AM
College
School of Osteopathic Medicine
Poster Abstract
Background: Osteochondral lesions of the knee may require cartilage restoration such as osteochondral allograft (OCA) transplantation or autologous chondrocyte implantation (ACI). Although MRI and arthroscopy can offer valuable information regarding lesion characteristics prior to these procedures, no study has compared the use of each in estimating the sizes of grafts used at the time of surgical correction.
Hypothesis/Purpose: To compare osteochondral defect size measurements and characteristics across MRI, arthroscopy, and at the time of implantation with OCA or ACI. Study Design: Retrospective Cohort Study (Level III)
Methods: Patients who underwent ACI and OCA transplantation at a single institution between 2015 and 2019 were retrospectively identified. Osteochondral lesion characteristics including size were collected preoperatively from MRI and arthroscopy and at the time of definitive open surgical intervention. Subgroup analysis was performed comparing measurement techniques depending on the corrective surgical approach used as well as depending on the mechanism of chondral injury to determine if these had any effect on the ability of arthroscopy or MRI to predict graft size.
Results: Overall, 136 chondral lesions were addressed with restoration procedures in 117 patients (mean age 32.5 years). Average difference between final graft size and lesion area measured with index arthroscopy was 116 mm2, while average difference between final graft size and lesion size measured with preoperative MRI was 182 mm2 (P < .001). Depending on surgical technique, measurements with MRI were more similar to final graft size when a patient underwent OCA transplantation versus ACI (P = .007). Depending on mechanism of injury, MRI measurements of lesions were closer to graft area when lesions resulted from trauma (P = .047).
Conclusion: Chondral lesion size determined by preoperative MRI imaging is less accurate than arthroscopic measurements. The mechanism injury leading to chondral damage and degree of damage may influence the ability of MRI and arthroscopy to accurately measure chondral lesions and predict the final graft size used in surgical correction. Future studies may be warranted to further investigate influencing factors that alter the reliability of arthroscopy and MRI in measuring chondral lesions.
Magnetic Resonance
Keywords
Subchondral Arthroplasty, Allografts, Knee, Cartilage, Musculoskeletal Diseases, Magnetic Resonance Imaging
Disciplines
Medicine and Health Sciences | Musculoskeletal Diseases | Orthopedics | Surgery
Document Type
Poster
Determining Accuracy of Chondral Lesion Sizing Methods Prior to Surgery
Background: Osteochondral lesions of the knee may require cartilage restoration such as osteochondral allograft (OCA) transplantation or autologous chondrocyte implantation (ACI). Although MRI and arthroscopy can offer valuable information regarding lesion characteristics prior to these procedures, no study has compared the use of each in estimating the sizes of grafts used at the time of surgical correction.
Hypothesis/Purpose: To compare osteochondral defect size measurements and characteristics across MRI, arthroscopy, and at the time of implantation with OCA or ACI. Study Design: Retrospective Cohort Study (Level III)
Methods: Patients who underwent ACI and OCA transplantation at a single institution between 2015 and 2019 were retrospectively identified. Osteochondral lesion characteristics including size were collected preoperatively from MRI and arthroscopy and at the time of definitive open surgical intervention. Subgroup analysis was performed comparing measurement techniques depending on the corrective surgical approach used as well as depending on the mechanism of chondral injury to determine if these had any effect on the ability of arthroscopy or MRI to predict graft size.
Results: Overall, 136 chondral lesions were addressed with restoration procedures in 117 patients (mean age 32.5 years). Average difference between final graft size and lesion area measured with index arthroscopy was 116 mm2, while average difference between final graft size and lesion size measured with preoperative MRI was 182 mm2 (P < .001). Depending on surgical technique, measurements with MRI were more similar to final graft size when a patient underwent OCA transplantation versus ACI (P = .007). Depending on mechanism of injury, MRI measurements of lesions were closer to graft area when lesions resulted from trauma (P = .047).
Conclusion: Chondral lesion size determined by preoperative MRI imaging is less accurate than arthroscopic measurements. The mechanism injury leading to chondral damage and degree of damage may influence the ability of MRI and arthroscopy to accurately measure chondral lesions and predict the final graft size used in surgical correction. Future studies may be warranted to further investigate influencing factors that alter the reliability of arthroscopy and MRI in measuring chondral lesions.
Magnetic Resonance