T2-mapping MRI evaluation of patellofemoral cartilage in patients submitted to intra-articular platelet-rich plasma (PRP) injections

Abstract

This study evaluated the ability of T2 mapping magnetic resonance imaging at 3 T, in addition to morphological sequences, to assess efficacy of platelet-rich plasma (PRP) injections, characterizing qualitatively and quantitatively the grade of knee cartilage repair in patients with patellofemoral chondropathy. We retrospectively studied 34 patients (22 men, 12 women, mean age 41.8 years, including 22 men) with patellofemoral knee chondropathy, who underwent intra-articular PRP injections and completed a clinical and instrumental follow-up. As control group, we evaluated 34 patients who underwent non-operative therapy. All patients were submitted to clinical (using VAS and WOMAC index) and imaging studies with 3 T magnetic resonance with cartilage analysis with T2 mapping sequences for cartilage analysis before and after treatment. In the study group, mean pre-treatment T2 relaxation time values were 44.2 ± 2.5 ms, considering all articular cartilage compartments, with significant reduction at the follow-up (p < 0.001). At the index compartment, mean pre-treatment T2 relaxation times values were 47.8 ± 3.6 ms, with statistically significant reduction at the follow-up (p < 0.001). Evaluation of focal cartilage lesions reported pre-treatment mean T2 value of 70.1 ± 13.0 ms and post-treatment mean value of 59.9 ± 4.6 ms (p < 0.001). From a clinical point of view, the pre-treatment WOMAC and VAS scores were 18.3 ± 4.5 and 7 (IQR:6–7.2), respectively; the post-treatment values were 7.3 ± 3.2 and 2 (IQR: 1.7–3.0), respectively (p < 0.001). In the control group, despite clinical improvement, we didn’t find significant T2 values change during the follow-up period. In conclusion, T2 mapping is a valuable indicator for chondropathy and treatment-related changes over time.

Real-world evidence to assess the effectiveness of platelet-rich plasma in the treatment of knee degenerative pathology: a prospective observational study

“… 26 Very few studies have evaluated the effect of PRP in chondromalacia patellae achieving good results both in imaging and clinical studies. 27 – 29 This treatment should be considered an option not only for the improvement of the patient but also to attempt to prevent more serious conditions such as patellofemoral osteoarthritis.…”

The role of Platelet-Rich Plasma (PRP) intraarticular injections in restoring articular cartilage of osteoarthritic knees. A systematic review and meta-analysis

“…The search identified 1452 records by title, 14 of which met the inclusion criteria and were included for the analysis [ 10 , 11 , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] ]. Fig.…”

“…Table 1 summarises the characteristics of the 14 included studies [ 10 , 11 , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] ]. The methodology of the non-randomised studies was classified according to Mathes and Pieper (2017) [ 30 ].…”

“…The methodology of the non-randomised studies was classified according to Mathes and Pieper (2017) [ 30 ]. Our analysis included seven RCTs (n ​= ​688) [ [10] , [11] , [19] , [22] , [26] , [31] , [32] ]; two prospective (n ​= ​119) [ [24] , [25] ]; one retrospective cohort (n ​= ​68) [ 21 ]; and 4 case-series (n ​= ​244) [ 20 , 23 , 27 , 28 ]. The total number of participants included was 1119 (1,169TKAs).…”

Multimodality Imaging Assessment of Desmoid Tumors: The Great Mime in the Era of Multidisciplinary Teams

“…Since the management of DTs mandates a multidisciplinary approach, imaging plays a pivotal role in the detection and assessment of these lesions. In the correct radiological disease management, multimodality imaging, including ultrasound (US), Computed Tomography (CT) and Magnetic Resonance Imaging (MRI), should also be preferred concerning the different phases of DTs approaches [ 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 ]. In fact, during radiologist work-up, different moments may be considered: detection and characterization, adjacent structures involvement assessment, treatment response evaluation and surveillance [ 93 , 94 , 95 , 96 , 97 , 98 , 99 , 100 , 101 , 102 , 103 , 104 , 105 , 106 , 107 , 108 , 109 , 110 ].…”