Reliability of the MOCART (Magnetic Resonance Observation of Cartilage Repair Tissue) 2.0 knee score for different cartilage repair techniques—a retrospective observational study

Abstract

Objectives To evaluate the reliability of the MOCART 2.0 knee score in the radiological assessment of repair tissue after different cartilage repair procedures. Methods A total of 114 patients (34 females) who underwent cartilage repair of a femoral cartilage lesion with at least one postoperative MRI examination were selected, and one random postoperative MRI examination was retrospectively included. Mean age was 32.5 ± 9.6 years at time of surgery. Overall, 66 chondral and 48 osteochondral lesions were included in the study. Forty-eight patients were treated with autologous chondrocyte implantation (ACI), 27 via osteochondral autologous transplantation, five using an osteochondral scaffold, and 34 underwent microfracture (MFX). The original MOCART and MOCART 2.0 knee scores were assessed by two independent readers. After a minimum 4-week interval, both readers performed a second reading of both scores. Inter- and intrarater reliabilities were assessed using intraclass correlation coefficients (ICCs). Results The MOCART 2.0 knee score showed higher interrater reliability than the original MOCART score with an ICC of 0.875 versus 0.759, ranging from 0.863 in the MFX group to 0.878 in the ACI group. Intrarater reliability was good with an overall ICC of 0.860 and 0.866, respectively. Overall, interrater reliability was higher for osteochondral lesions than for chondral lesions, with ICCs of 0.906 versus 0.786. Conclusions The MOCART 2.0 knee score enables the assessment of cartilage repair tissue after different cartilage repair techniques (ACI, osteochondral repair techniques, MFX), as well as for different lesion types with good intra- and interrater reliability. Key Points • The MOCART 2.0 knee score provides improved intra- and interrater reliability when compared to the original MOCART score. • The MOCART 2.0 knee score enables the assessment of cartilage repair tissue after different cartilage repair techniques (ACI, osteochondral repair techniques, MFX) with similarly good intra- and interrater reliability. • The assessment of osteochondral lesions demonstrated better intra- and interrater reliability than the assessment of chondral lesions in this study.

Loose Body Versus Trochlear Biopsy Matrix-Induced Autologous Chondrocyte Implantation (MACI) MOCART Scores and IKDC Reported Outcomes in Pediatric Patients

“…The MOCART scoring system serves as an objective evaluation of graft health and incorporation obviating the need for a postimplantation arthroscopy or biopsy. We had excellent interobserver reliability between observers with an ICC of 0.94, which is similar to previous studies where the MOCART 2.0 scoring system was used in the assessment of OCD lesions 32. Utilizing osteochondral loose bodies to harvest chondrocytes in place of standard intercondylar biopsies can mitigate morbidity risk while resulting in similar radiographic and patient-reported outcomes.…”

“…We had excellent interobserver reliability between observers with an ICC of 0.94, which is similar to previous studies where the MOCART 2.0 scoring system was used in the assessment of OCD lesions. 32 Utilizing osteochondral loose bodies to harvest chondrocytes in place of standard intercondylar biopsies can mitigate morbidity risk while resulting in similar radiographic and patient-reported outcomes. The risk of donor site morbidity is particularly concerning in pediatric patients where a large biopsy is taken from a skeletally immature distal femur.…”

Minced Autologous Chondral Fragments with Fibrin Glue as a Simple Promising One-Step Cartilage Repair Procedure: A Clinical and MRI Study at 12-Month Follow-Up

“…In contrast to a retrospective study by Schreiner et al . 72 of 114 OCL repairs by means of microfracture, OATS, and ACI, defects smaller than 2.5 cm 2 had significant higher MOCART scores than larger defects. Moreover, defects of the LFC had significantly higher MOCART scores compared to MFC defects.…”

Adipose Tissue-Derived Mesenchymal Stem Cells as a Potential Restorative Treatment for Cartilage Defects: A PRISMA Review and Meta-Analysis

“…It comprises of nine pertinent variables, including (1) the degree of filling of the defect; (2) the integration to the border zone; (3) the description of the surface; (4) description of the structure; (5) the signal intensity; (6) the status of the subchondral lamina; (7) the status of the subchondral bone; (8) the appearance of adhesions; (9) the presence of synovitis. This allows for the quantification of post-operative morphological MRI results and evaluation of repair, comparing the repaired tissue with adjacent cartilage [49]. Final MOCART scores of studies were extracted as the studies conducted MOCART scoring at different time points.…”