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Imaging in Cartilage Restoration

  • Goetz H. Welsch
Chapter

Abstract

Imaging of cartilage and cartilage repair is of utmost importance to diagnose possible cartilage defects and after cartilage restoration to assess the success of the cartilage therapy. Morphological magnetic resonance imaging (MRI) is considered the gold standard to assess joint anatomy and possible injuries or overuse in detail. Besides ligaments and other soft tissue, e.g., the meniscus in the knee joint or the acetabular labrum in the hip, the cartilage can be depicted in detail. Possible cartilage defects, acute and chronic cartilage injuries, as well as osteochondral defects can be visualized. A preoperative scoring and classification system for the assessment of preoperative cartilage defect severity was implemented recently with the Area Measurement And DEpth and Underlying Structures (AMADEUS) score. Comparably after cartilage repair, the repair tissue and the adjacent structures, as well as the whole joint, can be diagnosed. In the postoperative follow-up, the Magnetic resonance Observation of Cartilage Repair Tissue (MOCART) scoring system has been shown to provide a valid instrument to assess the site where cartilage repair has taken place. A more detailed evaluation of the repair tissue together with the whole joint can be achieved by the Cartilage Repair Osteoarthritis Knee Score (CROAKS).

Due to high-field MR systems, advanced coil technology, and sophisticated sequence protocols, biochemical MRI is capable of visualizing the composition of cartilage and cartilage repair tissue based on its hydration, its collagen matrix, and its glycosaminoglycan (GAG) content. Cartilage physiology and ultrastructure can be determined, changes in cartilage macromolecules can be detected, cartilage repair tissue maturation can thus be assessed, and the quality of the repair tissue can be differentiated, e.g., after different cartilage repair procedures.

Keywords

MRI Cartilage repair AMDEUS MOCART CROAKS Morphological MRI Biochemical MRI T2 mapping dGEMRIC 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Goetz H. Welsch
    • 1
  1. 1.UKE Athleticum, University Hospital Hamburg-Eppendorf (UKE)HamburgGermany

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