Autogenous osteochondral "plug" transfer for the treatment of focal chondral defects: postoperative MR appearance with clinical correlation

被引:83
作者
Sanders, TG
Mentzer, KD
Miller, MD
Morrison, WB
Campbell, SE
Penrod, BJ
机构
[1] USAF, Med Ctr, Dept Radiol, Lackland AFB, TX 78236 USA
[2] Univ Texas, Hlth Sci Ctr, Dept Radiol, San Antonio, TX 78284 USA
[3] Wilford Hall USAF Med Ctr, Dept Radiol, Lackland AFB, TX 78236 USA
[4] Wilford Hall USAF Med Ctr, Dept Orthopaed, Lackland AFB, TX 78236 USA
[5] Univ Virginia, Dept Orthopaed Surg, Charlottesville, VA 22908 USA
关键词
cartilage; MR; knee; surgery;
D O I
10.1007/s002560100371
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Objective. To describe the MR appearance following autogenous osteochondral "plug" transfer for the treatment of focal chondral defects of the knee. Design and patients. Twenty-nine 1.5-T MR knee studies including dynamic gadolinium enhancement were performed on 21 patients following autogenous osteochondral "plug" transfer. Three musculoskeletal radiologists retrospectively reviewed images to evaluate graft and donor site appearance and MR findings were correlated with clinical outcomes. Results. MR images demonstrated graft protuberance (n=12/21; range 1-2 mm), depression (n=2/21; range I mm), and surface incongruity: mild (n=17/21), moderate (n=2/21), marked (n=1/21). The T2 signal of graft cartilage was similar to that of adjacent cartilage in 25 of 29 examinations, and increased in four. Graft cartilage thickness relative to adjacent cartilage was < 50% in six patients, 50-100% in 15. Graft enhancement in bone was absent at 2 weeks, but present at between 4 and 6 weeks following surgery. All patients had clinical follow-up examinations and knee outcome survey scores were obtained in 15 patients with follow-up greater than 3 months after surgery. All patients demonstrated the expected short-term progressive clinical improvement. Conclusion. MR images reveal a wide range of appearances following osteochondral "plug" transfer. Minor variations in graft orientation and surface congruity do not result in adverse clinical outcome in the short term.
引用
收藏
页码:570 / 578
页数:9
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