MR imaging for surgical planning and postoperative assessment in early osteoarthritis

Articular cartilage lesions in young active patients are a common problem encountered by orthopedic surgeons. Because of the lack of vascularity, isolated chondral lesions in young active patients do not heal spontaneously and may lead to osteoarthritis. Arthroscopic lavage and debridement provide temporary symptomatic relief without addressing the underlying pathology. Marrow stimulation techniques fill the defects with biomechanically inferior fibrocartilage. Osteoarticular autografts are useful for small lesions but are technically demanding. Autologous chondrocyte implantation can provide durable hyaline cartilage even in salvage reconstruction scenarios. Arthroplasty remains the ultimate salvage for the arthritic joint, but biomechanical limitations preclude its use in young athletic adults. MR imaging is valuable in diagnosis and treatment planning for chondral lesions and in following cartilage reconstructions longitudinally. It may reduce the need for more costly and invasive diagnostic arthroscopy,