Because of the relative avascularity of articular cartilage, lesions that are caused by trauma or degeneration of the cartilage do not heal spontaneously and must be repaired surgically. The interventional procedures that have been developed for the repair of such lesions include abrasion, microfracture, autologous osteochondral transplantation, allograft transplantation, and autologous chondrocyte implantation. An accurate imaging assessment of the repair tissue is necessary in order to objectively evaluate the postoperative outcome. Magnetic resonance (MR) imaging and arthroscopy provide complementary information and are especially useful for follow-up evaluation of cartilage repair in the knee and ankle. Standard MR imaging techniques may be used postoperatively to evaluate the success of implantation and the state of cartilage healing. Newer matrix assessment techniques, which include delayed gadolinium-enhanced MR imaging and mapping of T1rho and T2 values, may provide useful supplemental information about the histologic and biochemical contents of reparative tissue. The normal postoperative appearance of the joints after cartilage repair varies according to the surgical technique used and the stage of healing. To identify potential complications, it is important to be familiar with the various repair procedures and the characteristic MR imaging features of the repair tissue at various postoperative intervals.
The performance of 3D SPACE sequences is comparable to that of 2D proton density-weighted MR images for the diagnosis of acute and chronic syndesmosis injuries.
BackgroundThis study was designed to perform conventional ultrasonography, magnetic resonance arthrography (MRA) and arthrosonography exams after rotator cuff repair to compare the results of conventional ultrasonography and arthrosonography with those of MRA as the gold standard.MethodsWe prospectively studied 42 consecutive patients (14 males, 28 females; average age, 59.4 years) who received arthroscopic rotator cuff repair due to full-thickness tears of the supraspinatus tendon from 2008 to 2010. The integrity assessment of the repaired rotator cuff was performed 6 months postoperatively using conventional ultrasonography, MRA, and arthrosonography.ResultsThe diagnostic accuracy of the conventional ultrasonography compared to MRA was 78.6% and the McNemar test results were 0.016 in full-thickness tear and 0.077 in partial-thickness tear. The diagnostic accuracy of arthrosonography compared to MRA was 92.9% and the McNemar test results were 0.998 in full-thickness tear and 0.875 in partial-thickness tear.ConclusionsIt was found that the integrity assessment of the repaired rotator cuff by ultrasonography must be guarded against and that arthrosonography is an effective alternative method in the postoperative integrity assessment. Also, an arthrosonography seems to be a suitable modality to replace the conventional ultrasonography.
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