Minimally Invasive Ultrasound Method for Intra-Articular Diagnostics of Cartilage Degeneration

Virén, Tuomas; Saarakkala, Simo; Kaleva, Erna; Nieminen, Heikki J.; Jurvelin, Jukka S.; Töyräs, Juha

doi:10.1016/j.ultrasmedbio.2009.04.004

Cited by 50 publications

(53 citation statements)

References 32 publications

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“…In addition to acquisition of high-resolution ultrasound images, we determined qualitative and quantitative ultrasound parameters which correlated with the ICRS grading scores, as derived from conventional arthroscopy. Our results are consistent with earlier studies where this technique was tested in vitro, 11,21 in an animal joint ex vivo, 35 and in vivo in clinical arthroscopy of the human knee joint. 12 Arthroscopic ultrasound was found to be more effective in detecting early stage cartilage damage compared to the 1.5 T routine clinical magnetic resonance imaging.…”

Section: Discussionsupporting

confidence: 92%

“…3,4 Ultrasound imaging has been proposed as a potential method to meet these needs. [5][6][7][8][9][10][11][12] With ultrasound, quantitative evaluation of articular cartilage integrity, 11,12 surface roughness and composition is possible. [13][14][15][16][17][18][19][20][21][22][23]26 We recently introduced an ultrasound arthroscopy technique for clinical assessment of articular cartilage and subchondral bone integrity.…”

Section: Introductionmentioning

confidence: 99%

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In Vivo Evaluation of the Potential of High-Frequency Ultrasound for Arthroscopic Examination of the Shoulder Joint

et al. 2016

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Objective. Accurate arthroscopic evaluation of cartilage lesions could significantly improve the outcome of repair surgery. In this study, we investigated for the first time the potential of intra-articular ultrasound as an arthroscopic tool for grading cartilage defects in the human shoulder joint in vivo and compared the outcome to results from arthroscopic evaluation and magnetic resonance imaging findings. Design. A total of 26 sites from 9 patients undergoing routine shoulder arthroscopy were quantitatively evaluated with a clinical intravascular (40MHz) ultrasound imaging system, using the regular arthroscopy portals. Reflection coefficient (R), integrated reflection coefficient (IRC), apparent integrated backscattering (AIB), and ultrasound roughness index (URI) were calculated, and high-resolution ultrasound images were obtained per site. Each site was visually graded according to the International Cartilage Repair Society (ICRS) system. "Ultrasound scores" corresponding to the ICRS system were determined from the ultrasound images. Magnetic resonance imaging was conducted and cartilage integrity at each site was classified into 5 grades (0 = normal, 4 = severely abnormal) by a radiologist. Results. R and IRC were lower at sites with damaged cartilage surface (P = 0.033 and P = 0.043, respectively) and correlated with arthroscopic ICRS grades (r s = −0.444, P = 0.023 and r s = −0.426, P = 0.03, respectively). Arthroscopic ICRS grades and ultrasound scores were significantly correlated (rs = 0.472, P = 0.015), but no significant correlation was found between magnetic resonance imaging data and other parameters. Conclusion. The results suggest that ultrasound arthroscopy could facilitate quantitative clinical appraisal of articular cartilage integrity in the shoulder joint and provide information on cartilage lesion depth and severity for quantitative diagnostics in surgery.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

In Vivo Evaluation of the Potential of High-Frequency Ultrasound for Arthroscopic Examination of the Shoulder Joint

et al. 2016

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“…Moreover, the organized structure of the collagen network gives rise to a magic angle effect in T2-weighted sequences, which in turn allows an indirect assessment of the orientation of the collagen fibers. Compared to these MRI evaluation techniques, UBM has several complementary potentials: The spatial resolution of UBM is one order of magnitude better than current conventional MRI systems, which allows a separate evaluation of the individual cartilage layers , and which provides a high sensitivity to surface roughness (Viren et al, 2009). Furthermore, the elastic interaction of the ultrasound wave with the tissue delivers information on alterations of matrix elasticity, collagen orientation, packing density, as well as a depth-dependent information on number, size and shape of cells in the subsuperficial layers .…”

Section: Analysis Of Cartilage Repair Tissuesmentioning

confidence: 99%

“…Recently, small ultrasound transducers, that were originally intended for intravascular use, have been shown to be also suited for the analysis of cartilage tissue and even for direct intraarticular diagnostics of articular cartilage (Huang et al, 2009;Viren et al, 2009). Such miniaturized catheter-based devices could be further www.ecmjournal.org K Gelse et al Ultrasound analysis of cartilage repair tissues established for arthroscopic use in the operation theatre, which would then allow real-time evaluation and monitoring of cartilage repair tissues in clinical settings.…”

Section: Analysis Of Cartilage Repair Tissuesmentioning

confidence: 99%

Quantitative ultrasound biomicroscopy for the analysis of healthy and repair cartilage tissue

Gelse

Olk²,

Eichhorn³

et al. 2010

eCM

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The increasing spectrum of different cartilage repair strategies requires the introduction of adequate nondestructive methods to analyse their outcome in-vivo, i.e. arthroscopically. The validity of non-destructive quantitative ultrasound biomicroscopy (UBM) was investigated in knee joints of five miniature pigs. After 12 weeks, six 5-mm defects, treated with different cartilage repair approaches, provided tissues with different structural qualities. Healthy articular cartilage from each contralateral unoperated knee joint served as a control. The reflected and backscattered ultrasound signals were processed to estimate the integrated reflection coefficient (IRC) and apparent integrated backscatter (AIB) parameters. The cartilage repair tissues were additionally assessed biomechanically by cyclic indentation, histomorphologically and immunohistochemically. UBM allowed high-resolution visualisation of the structure of the joint surface and subchondral bone plate, as well as determination of the cartilage thickness and demonstrated distinct differences between healthy cartilage and the different repair cartilage tissues with significant higher IRC values and a steeper negative slope of the depth-dependent backscatter amplitude AIB slope for healthy cartilage. Multimodal analyses revealed associations between IRC and the indentation stiffness. Furthermore, AIB slope and AIB at the cartilage-bone boundary (AIB dC ) were associated with the quality of the repair matrices and the subchondral bone plate, respectively. This ex-vivo pilot study confirms that UBM can provide detailed imaging of articular cartilage and the subchondral bone interface also in repaired cartilage defects, and furthermore, contributes in certain aspects to a basal functional characterization of various forms of cartilage repair tissues. UBM could be further established to be applied arthroscopically in-vivo.

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“…So far, the common method to accomplish that, are specific experimental assays (Pearle et al 2005;Albro et al 2009;Virén et al 2009). However, these techniques require high costs and elevate time consuming.…”

Section: Introductionmentioning

confidence: 99%

Parameter-dependent behavior of articular cartilage: 3D mechano-electrochemical computational model

Manzano

Doblaré

Doweidar

2015

Computer Methods and Programs in Biomedicine

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Minimally Invasive Ultrasound Method for Intra-Articular Diagnostics of Cartilage Degeneration

Cited by 50 publications

References 32 publications

In Vivo Evaluation of the Potential of High-Frequency Ultrasound for Arthroscopic Examination of the Shoulder Joint

In Vivo Evaluation of the Potential of High-Frequency Ultrasound for Arthroscopic Examination of the Shoulder Joint

Quantitative ultrasound biomicroscopy for the analysis of healthy and repair cartilage tissue

Parameter-dependent behavior of articular cartilage: 3D mechano-electrochemical computational model

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