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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Magnetic Resonance Imaging Parameters at 1 Year Correlate With Clinical Outcomes Up to 17 Years After Autologous Chondrocyte Implantation
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Magnetic Resonance Imaging Parameters at 1 Year Correlate With Clinical Outcomes Up to 17 Years After Autologous Chondrocyte Implantation

机译：自体软骨细胞植入后1年的磁共振成像参数与长达17年的临床结果相关

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Background: The ability to predict the long-term success of surgical treatment in orthopaedics is invaluable, particularly in clinical trials. The quality of repair tissue formed 1 year after autologous chondrocyte implantation (ACI) in the knee was analyzed and compared with clinical outcomes over time. Hypothesis: Better quality repair tissue and a better appearance on magnetic resonance imaging (MRI) 1 year after ACI lead to improved longer-term clinical outcomes. Study Design: Cohort study; Level of evidence, 3. Methods: Repair tissue quality was assessed using either MRI (11.5 ± 1.4 [n = 91] or 39.2 ± 18.5 [n = 76] months after ACI) or histology (16.3 ± 11.0 months [n = 102] after ACI). MRI scans were scored using the whole-organ magnetic resonance imaging score (WORMS) and the magnetic resonance observation of cartilage repair tissue (MOCART) score, with additional assessments of subchondral bone marrow and cysts. Histology of repair tissue was performed using the Oswestry cartilage score (OsScore) and the International Cartilage Repair Society (ICRS) II score. Clinical outcomes were assessed using the modified Lysholm score preoperatively, at the time of MRI or biopsy, and at a mean 8.4 ± 3.7 years (maximum, 17.8 years) after ACI. Results: At 12 months, the total MOCART score and some of its individual parameters correlated significantly with clinical outcomes. The degree of defect fill, overall signal intensity, and surface of repair tissue at 12 months also significantly correlated with longer-term outcomes. The presence of cysts or effusion (WORMS) significantly correlated with clinical outcomes at 12 months, while the presence of synovial cysts/bursae preoperatively or the absence of loose bodies at 12 months correlated significantly with long-term clinical outcomes. Thirty percent of repair tissue biopsies contained hyaline cartilage, 65% contained fibrocartilage, and 5% contained fibrous tissue. Despite no correlation between the histological scores and clinical outcomes at the time of biopsy, a lack of hyaline cartilage or poor basal integration was associated with increased pain; adhesions visible on MRI also correlated with significantly better histological scores. Conclusion: These results demonstrate that MRI at 12 months can predict longer-term clinical outcomes after ACI. Further investigation regarding the presence of cysts, effusion, and adhesions and their relationship with histological and clinical outcomes may yield new insights into the mechanisms of cartilage repair and potential sources of pain.
机译：背景：预测骨科手术治疗长期成功的能力非常宝贵，尤其是在临床试验中。分析了自体软骨细胞植入（ACI）膝盖1年后形成的修复组织的质量，并将其与随时间的临床结果进行比较。假设：ACI一年后，修复组织的质量更高，磁共振成像（MRI）外观更佳，从而改善了长期临床疗效。研究设计：队列研究;证据等级，3。方法：使用MRI（ACI后11.5±1.4 [n = 91]或39.2±18.5 [n = 76]月）或组织学（16.3±11.0个月[n = 102]）评估修复组织的质量。在ACI之后）。使用全器官磁共振成像评分（WORMS）和软骨修复组织的磁共振观察评分（MOCART）评分MRI扫描，并进一步评估软骨下骨髓和囊肿。使用Oswestry软骨评分（OsScore）和国际软骨修复学会（ICRS）II评分进行修复组织的组织学检查。术前，MRI或活检时，平均ACI后平均8.4±3.7年（最长17.8年），使用改良的Lysholm评分评估临床结局。结果：在12个月时，MOCART总评分及其某些参数与临床结果显着相关。缺损的程度，总体信号强度和12个月时修复组织的表面也与长期预后显着相关。术前12个月囊肿或积液（WORMS）的存在与临床结局显着相关，术前12个月滑膜囊肿/滑囊的存在或无松散体与长期临床结局显着相关。修复组织活检的30％包含透明软骨，65％包含纤维软骨，5％包含纤维组织。尽管活检时组织学评分与临床结果之间无相关性，但缺乏透明软骨或基础整合不良会增加疼痛。 MRI上可见的粘连也与组织学评分明显改善相关。结论：这些结果表明，MRI在12个月时可以预测ACI后的长期临床结局。有关囊肿，积液和粘连的存在及其与组织学和临床结果的关系的进一步研究可能会为软骨修复的机制和潜在的疼痛来源提供新的见解。

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