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Arthroscopic autologous chondrocyte implantation in osteochondral lesions of the talus: mid-term T2-mapping MRI evaluation

  • Ankle
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Autologous chondrocyte implantation (ACI) in the ankle has become an established procedure to treat osteochondral lesions. However, a non-invasive method able to provide information on the nature of the repair tissue is needed. Recently, MRI T2 mapping was identified as a method capable of qualitatively characterizing articular cartilage. The aim of this study was to evaluate the mid-term results of a series of patients arthroscopically treated by ACI and investigate the nature of the repair tissue by MRI T2 mapping.

Methods

Twenty patients, aged 35 ± 8 years, with an osteochondral lesion of the talus, underwent ACI and were evaluated at 5 ± 1 years’ follow-up clinically (AOFAS score) and by the MRI T2-mapping sequence. MRI images were acquired using a protocol proposed by the International Cartilage Repair Society, evaluated by the MOCART score and completed by the T2-mapping sequence. Healthy volunteers, mean age 29 ± 6 years, were enrolled, and their T2 map values were used as a control. Their MRI results were then correlated with the clinical score.

Results

The AOFAS score increased from 59 ± 16 pre-operatively to 84 ± 18 at follow-up (P < 0.0005). Patients with more than 4 years’ follow-up were found to have the most satisfactory results. On the basis of the controls, healthy hyaline cartilage tissue showed a T2 map value of 35–45 ms. A mean T2 map value compatible with normal hyaline cartilage was found in all the cases treated, covering a mean percentage of 69% ± 22 of the repaired lesion area.

Conclusions

ACI was able to provide durable results that improved over time. Because of its ability to detect cartilage quality, the MRI T2-mapping sequence integrated with the Mocart score is a valid, non-invasive technique in evaluating the nature of the repair tissue in the ankle joint.

Level of evidence

Therapeutic study, Level IV.

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Authors and Affiliations

  1. Clinical Orthopaedic and Traumatology Unit II, Rizzoli Orthopaedic Institute, via G.C. Pupilli n.1, Bologna, Italy

    Francesca Vannini, Roberto Buda, Marco Cavallo, Alberto Ruffilli & Sandro Giannini

  2. Service of Ecography and Radiology, Rizzoli Orthopaedic Institute, Bologna, Italy

    Milva Battaglia & Stefano Galletti

  3. Service of CT and MRI, Casa di Cura Madre Fortunata Toniolo, Bologna, Italy

    Carlo Monti

Authors
  1. Milva Battaglia
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  2. Francesca Vannini
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  3. Roberto Buda
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  4. Marco Cavallo
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  5. Alberto Ruffilli
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  6. Carlo Monti
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  7. Stefano Galletti
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  8. Sandro Giannini
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Correspondence to Francesca Vannini.

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Battaglia, M., Vannini, F., Buda, R. et al. Arthroscopic autologous chondrocyte implantation in osteochondral lesions of the talus: mid-term T2-mapping MRI evaluation. Knee Surg Sports Traumatol Arthrosc 19, 1376–1384 (2011). https://doi.org/10.1007/s00167-011-1509-x

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  • DOI: https://doi.org/10.1007/s00167-011-1509-x

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