Normal and pathological MR findings in osteochondral autografts with longitudinal follow-up

Abstract

The purpose of this study was to analyze normal and pathological MR findings in osteochondral autograft transfer systems (OATS) of the knee and ankle in the longitudinal follow-up and in relation to the clinical findings. MR imaging was performed in 55 patients (21 females: 34 males; mean age 34.5+/-12.1 years) after OATS procedures in the knee (n=45) and ankle (n=10). MR sequences were obtained with and without intravenous Gd-DTPA administration within the first year post-operatively, in 30 patients within the second and in 13 patients in the third year. One hundred and five OATS cylinders were implanted. MR findings consistent with osteonecroses were detected in eight cylinders (n=6 in the knee and n=2 in the ankle) in six patients; four out of eight were demonstrated during the first year and four/eight in the second year. Edema around and/or in the cylinders was found in 28/55 of the patients within the first year, five/30 in the second year and in two/13 in the third year. No substantial changes in the cartilage signal intensity or the cartilage-cartilage interface were demonstrated in the longitudinal follow-up within the first three years. Clinical and MR findings were not consistently associated in particular in the patients with osteochondral autograft necroses.

Cartilage imaging: motivation, techniques, current and future significance

“…Mosaicplasty, also termed osteochondral autograft transplantation (OAT) or autologous osteochondral transplantation, is one of the most promising techniques that has been developed [4][5][6]. This technique is used most frequently at the knee and ankle joints, but has also been advocated in other joints such as the elbow to treat focal chondral or osteochondral defects due to injury, degeneration, osteochondritis dissecans or osteonecrosis.…”

Treatment of Large Osteochondral Defects with Spongiosaplasty and Collagen Type I Hydrogel-Based Autologous Chondrocyte Implantation

“…Complications associated with the transplantation of such cylinders include donor site morbidity in up to 30% (23), degenerative changes of the adjoining cartilage, insufficient graft integration with the surrounding cartilage (24), and graft devitalization due to deficient vascularization in 11% of cases (25,26). As a result biomechanical instability and consecutive graft sintering may occur.…”

Pre- and Postoperative Assessment in Joint Preserving and Replacing Surgery

“…A well-incorporated plug has uniform fatty signal intensity. 59,66 Bone marrow edema, synovitis, and joint effusion may be seen in the early postoperative period. These imaging findings should show a gradual reduction on the follow-up scans.…”