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Voronkova E, Melnikov I, Manzhurtsev A, Bozhko O, Vorobyev D, Akhadov T, Menshchikov P. T 2 Mapping of Patellar Cartilage After a Single First-Time Episode of Traumatic Lateral Patellar Dislocation. J Magn Reson Imaging 2024; 59:865-876. [PMID: 37316971 DOI: 10.1002/jmri.28857] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 05/29/2023] [Accepted: 05/30/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND In most cases, lateral patellar dislocation (LPD) is accompanied by chondral injury and may initiate gradual degeneration of patellar cartilage, which might be detected with a T2 mapping, a well-established method for cartilage lesions assessment. PURPOSE To examine short-term consequences of single first-time LPD in teenagers by T2 mapping of the patellar-cartilage state. STUDY TYPE Prospective. POPULATION 95 patients (mean age: 15.1 ± 2.3; male/female: 46/49) with first-time, complete, traumatic LPD and 51 healthy controls (mean age: 14.7 ± 2.2, male/female: 29/22). FIELD STRENGTH/SEQUENCE 3.0 T; axial T2 mapping acquired using a 2D turbo spin-echo sequence. ASSESSMENT MRI examination was conducted 2-4 months after first LPD. T2 values were calculated in manually segmented cartilage area via averaging over three middle level slices in six cartilage regions: deep, intermediate, superficial layers, and medial lateral parts. STATISTICAL TESTS ANOVA analysis with Tukey's multiple comparison test, one-vs.-rest logistic regression analysis. The threshold of significance was set at P < 0.05. RESULTS In lateral patellar cartilage, a significant increase in T2 values was found in deep and intermediate layers in both patient groups with mild (deep: 34.7 vs. 31.3 msec, intermediate: 38.7 vs. 34.6 msec, effect size = 0.55) and severe (34.8 vs. 31.3 msec, 39.1 vs. 34.6 msec, 0.55) LPD consequences as compared to controls. In the medial facet, only severe cartilage damage showed significant prolongation of T2 times in the deep layer (34.3 vs. 30.7 msec, 0.55). No significant changes in T2 values were found in the lateral superficial layer (P = 0.99), whereas mild chondromalacia resulted in a significant decrease of T2 in the medial superficial layer (41.0 vs. 43.8 msec, 0.55). DATA CONCLUSION The study revealed substantial difference in T2 changes after LPD between medial and lateral areas of patellar cartilage. EVIDENCE LEVEL 2 TECHNICAL EFFICACY STAGE: 2.
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Affiliation(s)
- Elena Voronkova
- Clinical and Research Institute of Emergency Pediatric Surgery and Trauma, Moscow, Russian Federation
- Emanuel Institute of Biochemical Physics, Russian Academy of Sciences, Moscow, Russian Federation
| | - Ilya Melnikov
- Clinical and Research Institute of Emergency Pediatric Surgery and Trauma, Moscow, Russian Federation
| | - Andrei Manzhurtsev
- Clinical and Research Institute of Emergency Pediatric Surgery and Trauma, Moscow, Russian Federation
- Emanuel Institute of Biochemical Physics, Russian Academy of Sciences, Moscow, Russian Federation
| | - Olga Bozhko
- Clinical and Research Institute of Emergency Pediatric Surgery and Trauma, Moscow, Russian Federation
| | - Denis Vorobyev
- Clinical and Research Institute of Emergency Pediatric Surgery and Trauma, Moscow, Russian Federation
| | - Tolib Akhadov
- Clinical and Research Institute of Emergency Pediatric Surgery and Trauma, Moscow, Russian Federation
| | - Petr Menshchikov
- Emanuel Institute of Biochemical Physics, Russian Academy of Sciences, Moscow, Russian Federation
- LLC Philips, Moscow, Russian Federation
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Von Heideken J, Iversen MD, Hellsten A, Askenberger M. Adaptation of the Banff Patellofemoral Instability Instrument (BPII) 2.0 into Swedish. Acta Orthop 2023; 94:537-542. [PMID: 37905565 PMCID: PMC10617520 DOI: 10.2340/17453674.2023.21194] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 07/07/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND AND PURPOSE The Banff Patellofemoral Instability Instrument (BPII) 2.0 is a patient-reported outcome measure (PROM) designed specifically for patellofemoral instability. We translated and adapted the BPII 2.0 into Swedish and assessed its psychometric properties. PATIENTS AND METHODS The BPII 2.0 was forward- and back-translated. Children aged 10-16 years with patellar dislocation and instability or recurrent dislocation were recruited. Children completed the Swedish BPII 2.0 and KOOS-Child during their initial visit (t0) and 1 week later (t1). Internal consistency and test-retest reliability were evaluated using intraclass correlation coefficients (ICCs) for the BPII 2.0 and KOOS-Child scores comparison. Pearson correlation coefficients examined concurrent validity of the Swedish BPII 2.0 subscales with KOOS-Child subscales. RESULTS 64 children (46 females), mean age 13.8 (10.0-16.3) years, participated. Time after patellar dislocation or surgery was 3-24 months. 55 patients (86%) returned the second BPII 2.0 and KOOS-Child after an average of 9 (5-22) days. There were no ceiling or floor effects for the total score of the new Swedish BPII 2.0 or for its subscales. BPII 2.0 demonstrated excellent internal consistency at t0 (ICC 0.96, 95% confidence interval [CI] 0.95-0.97) and at t1 (ICC 0.97, CI 0.95-0.98), as well as excellent test-retest reliability (ICC 0.97, CI 0.96-0.98). Concurrent validity of the BPII 2.0 subscales with KOOS-Child subscales was moderate to strong (rho 0.40-0.88). CONCLUSION The Swedish BPII 2.0 showed excellent internal consistency as well as excellent test-retest reliability and is a reliable and valid questionnaire.
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Affiliation(s)
- Johan Von Heideken
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Maura D Iversen
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; Brigham & Women's Hospital, Division of Rheumatology, Immunology & Immunity, Section of Clinical Sciences, and Department of Medicine, Harvard Medical School, Boston, USA
| | | | - Marie Askenberger
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
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Elias JJ, Li M, Yang M, Lartey R, Murray JP, Farrow LD, Winalski CS, Li X. Elevated Patellofemoral and Tibiofemoral T1ρ Relaxation Times Following a First Time Patellar Dislocation. Cartilage 2022; 13:19476035221102570. [PMID: 35676874 PMCID: PMC9189536 DOI: 10.1177/19476035221102570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE The study was performed to evaluate cartilage within the knee following a first-time patellar dislocation, using elevated MRI-based T1ρ relaxation times as an indicator of low proteoglycan concentration. The hypothesis is that MRI-based T1ρ relaxation times for patellofemoral and tibiofemoral cartilage are significantly longer for knees being treated for patellar dislocation than for healthy control knees. DESIGN Twenty-one subjects being treated for a first-time, unilateral dislocation of the patella and 16 healthy controls participated in MRI-based T1ρ relaxation time mapping. Mean relaxation times were quantified for patellofemoral and tibiofemoral regions for injured knees, the contralateral knees, and healthy controls. T1ρ values for each region were compared between the 3 groups with generalized estimating equations. Linear regressions were also performed to correlate T1ρ relaxation times with time from injury. RESULTS The knees with a disloction had longer T1ρ relaxation times than the contralateral knees and control group at the medial patella and longer relaxation times than the control group at the lateral tibia (P < 0.05). T1ρ relaxation times at the medial patella also decreased with time from injury (r2 = 0.21, P = 0.037). CONCLUSIONS Compositional changes to cartilage on the medial patella are related to traumatic impact during a dislocation. Potential exists for cartilage properties at the medial patella to improve with time. Cartilage degradation at the lateral tibia is not directly related to traumatic impact. The current baseline data are a starting point to characterize the pathway from a first-time dislocation to progressive cartilage degradation and osteoarthritis.
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Affiliation(s)
- John J. Elias
- Department of Research, Cleveland Clinic Akron General, Akron, OH, USA,John J. Elias, Department of Research, Cleveland Clinic Akron General, 1 Akron General Avenue, Akron, OH 44302, USA.
| | - Mei Li
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, USA
| | - Mingrui Yang
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, USA
| | - Richard Lartey
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, USA
| | - John P. Murray
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, USA
| | - Lutul D. Farrow
- Orthopaedic & Rheumatologic Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Carl S. Winalski
- Department of Diagnostic Radiology, Cleveland Clinic, Cleveland, OH, USA
| | - Xiaojuan Li
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, USA
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Atkinson HF, Birmingham TB, Moyer RF, Yacoub D, Kanko LE, Bryant DM, Thiessen JD, Thompson RT. MRI T2 and T1ρ relaxation in patients at risk for knee osteoarthritis: a systematic review and meta-analysis. BMC Musculoskelet Disord 2019; 20:182. [PMID: 31039785 PMCID: PMC6492327 DOI: 10.1186/s12891-019-2547-7] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 03/28/2019] [Indexed: 12/19/2022] Open
Abstract
Background Magnetic resonance imaging (MRI) T2 and T1ρ relaxation are increasingly being proposed as imaging biomarkers potentially capable of detecting biochemical changes in articular cartilage before structural changes are evident. We aimed to: 1) summarize MRI methods of published studies investigating T2 and T1ρ relaxation time in participants at risk for but without radiographic knee OA; and 2) compare T2 and T1ρ relaxation between participants at-risk for knee OA and healthy controls. Methods We conducted a systematic review of studies reporting T2 and T1ρ relaxation data that included both participants at risk for knee OA and healthy controls. Participant characteristics, MRI methodology, and T1ρ and T2 relaxation data were extracted. Standardized mean differences (SMDs) were calculated within each study. Pooled effect sizes were then calculated for six commonly segmented knee compartments. Results 55 articles met eligibility criteria. There was considerable variability between scanners, coils, software, scanning protocols, pulse sequences, and post-processing. Moderate risk of bias due to lack of blinding was common. Pooled effect sizes indicated participants at risk for knee OA had lengthened T2 relaxation time in all compartments (SMDs from 0.33 to 0.74; p < 0.01) and lengthened T1ρ relaxation time in the femoral compartments (SMD from 0.35 to 0.40; p < 0.001). Conclusions T2 and T1ρ relaxation distinguish participants at risk for knee OA from healthy controls. Greater standardization of MRI methods is both warranted and required for progress towards biomarker validation. Electronic supplementary material The online version of this article (10.1186/s12891-019-2547-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hayden F Atkinson
- School of Physical Therapy, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada.,Wolf Orthopaedic Biomechanics Laboratory, Fowler Kennedy Sport Medicine Clinic, University of Western Ontario, London, Ontario, Canada.,Bone and Joint Institute, University of Western Ontario, London, Ontario, Canada
| | - Trevor B Birmingham
- School of Physical Therapy, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada. .,Wolf Orthopaedic Biomechanics Laboratory, Fowler Kennedy Sport Medicine Clinic, University of Western Ontario, London, Ontario, Canada. .,Bone and Joint Institute, University of Western Ontario, London, Ontario, Canada. .,Musculoskeletal Rehabilitation, Elborn College, University of Western Ontario, London, Ontario, N6G 1H1, Canada.
| | - Rebecca F Moyer
- Bone and Joint Institute, University of Western Ontario, London, Ontario, Canada.,School of Physiotherapy, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Daniel Yacoub
- Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada
| | - Lauren E Kanko
- School of Physical Therapy, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada.,Wolf Orthopaedic Biomechanics Laboratory, Fowler Kennedy Sport Medicine Clinic, University of Western Ontario, London, Ontario, Canada.,Bone and Joint Institute, University of Western Ontario, London, Ontario, Canada
| | - Dianne M Bryant
- School of Physical Therapy, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada.,Wolf Orthopaedic Biomechanics Laboratory, Fowler Kennedy Sport Medicine Clinic, University of Western Ontario, London, Ontario, Canada.,Bone and Joint Institute, University of Western Ontario, London, Ontario, Canada
| | - Jonathan D Thiessen
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada.,Imaging Program, Lawson Health Research Institute, London, Ontario, Canada
| | - R Terry Thompson
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada.,Imaging Program, Lawson Health Research Institute, London, Ontario, Canada
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