1
|
Geurts J, Andrey F, Favre J, Hügle T, Omoumi P. Morphological and histological features of thicker cartilage at the posterior medial femoral condyle in advanced knee osteoarthritis. OSTEOARTHRITIS AND CARTILAGE OPEN 2024; 6:100502. [PMID: 39114819 PMCID: PMC11304846 DOI: 10.1016/j.ocarto.2024.100502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 07/07/2024] [Indexed: 08/10/2024] Open
Abstract
Objective To assess morphological and histological features of cartilage at the posterior medial condyle in advanced pre-prosthetic osteoarthritis (OA), which is notably thicker compared to non-OA knees. Design Cartilage thickness was measured pre-operatively using MRI in 10 subjects with medial femorotibial OA (mean age: 70.2 years). Posterior condyles were obtained during arthroplasty and cartilage thickness, relative collagen content and subchondral bone volume fraction (BV/TV) were determined using phosphotungstic acid (PTA)-enhanced micro-CT. Regions of interest (ROI) around the maximum cartilage thickness were further analyzed through histomorphometry (Mankin score) and immunohistochemistry (cell density and apoptosis rates). Results Maximum cartilage thickness was 2.63 ± 0.51 mm in vivo and 3.04 ± 0.55 mm ex vivo and both measurements were strongly correlated (r = 0.84, p = 0.003). Cartilaginous collagen content measured by PTA-enhanced micro-CT was negatively correlated with maximum cartilage thickness (r = -0.70, p = 0.02). Average subchondral BV/TV was 31.6 ± 3.4% and did not correlate with cartilage thickness. Extensive loss of proteoglycan staining and tidemark multiplication were common histomorphological features around the maximum cartilage thickness. Chondrocyte densities were 315 ± 67 and 194 ± 36 cells/mm2 at the superficial and transitional cartilage zones, respectively. Chondrocyte apoptosis rates were approximately 70% in both zones. Maximum cartilage thickness correlated with superficial chondrocyte densities (r = 0.79, p = 0.01). Conclusions Thicker cartilage at the posterior medial condyle in OA knees displayed degenerative changes both in cartilage tissue and at the osteochondral junction. Cartilage thickening may be influenced by alterations in the superficial zone, necessitating further investigation through molecular studies.
Collapse
Affiliation(s)
- Jeroen Geurts
- Department of Rheumatology, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), Lausanne, Switzerland
| | - François Andrey
- Department of Rheumatology, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), Lausanne, Switzerland
| | - Julien Favre
- Swiss BioMotion Lab, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), Lausanne, Switzerland
| | - Thomas Hügle
- Department of Rheumatology, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), Lausanne, Switzerland
| | - Patrick Omoumi
- Department of Radiology, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), Lausanne, Switzerland
| |
Collapse
|
2
|
Lineham B, Wijayathunga H, Moran E, Shuweihdi F, Gupta H, Pandit H, Wijayathunga N. A systematic review demonstrating correlation of MRI compositional parameters with clinical outcomes following articular cartilage repair interventions in the knee. OSTEOARTHRITIS AND CARTILAGE OPEN 2023; 5:100388. [PMID: 37560388 PMCID: PMC10407572 DOI: 10.1016/j.ocarto.2023.100388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 07/21/2023] [Indexed: 08/11/2023] Open
Abstract
OBJECTIVE Compositional-MRI parameters enable the assessment of cartilage ultrastructure. Correlation of these parameters with clinical outcomes is unclear. This systematic review investigated the correlation of various compositional- MRI parameters with clinical outcome measures following cartilage repair or regeneration interventions in the knee. DESIGN This study was registered with PROSPERO and reported in accordance with PRISMA. PubMed, Institute of Science Index, Scopus, Cochrane Central Register of Controlled Trials, and Embase databases were searched. All studies, regardless of type, that presented correlation of compositional- MRI parameters with clinical outcome measures were included. Two researchers independently performed data extraction and QUADAS-2 analysis. Compositional-MRI parameter change following intervention and correlation with clinical outcome measures were evaluated. RESULTS 19 studies were included. Risk of bias was generally low. 5 different compositional parameters were observed from the included studies. However, due to the significant variability in the reporting of compositional-MRI parameters across studies, meta-analyses were possible only for T2 values and T2 index values (T2 value of repair cartilage relative to normal cartilage). Correlation of T2 values of repair cartilage with clinical outcome score was r = 0.33 [0.15, 0.52]. Correlation of T2 index with clinical outcome score was r = 0.52 [0.32, 0.77]. CONCLUSIONS Correlation between T2 values and clinical outcome scores following knee cartilage repair were found. The heterogeneity of the correlations extracted from the included studies limited the scope for the meta-analysis. Thus, standardised, high-quality studies are required for better assessment of correlation between compositional MRI parameters and clinical outcome measures after cartilage repair. REGISTRATION NUMBER PROSPERO CRD42021287364.Study protocol available on PROSPERO website.
Collapse
Affiliation(s)
- Beth Lineham
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, UK
| | | | - Emma Moran
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | | | - Harun Gupta
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Hemant Pandit
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, UK
| | | |
Collapse
|
3
|
Femoral Cartilage Thickness in Knee Osteoarthritis Patients and Healthy Adults: An Ultrasound Measurement Comparison. ScientificWorldJournal 2023; 2023:3942802. [PMID: 36845755 PMCID: PMC9957620 DOI: 10.1155/2023/3942802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 01/31/2023] [Accepted: 02/04/2023] [Indexed: 02/19/2023] Open
Abstract
Background Currently, conventional radiography is still widely used to diagnose knee osteoarthritis and assess the grade according to Kallgren and Lawrence's criteria. Ultrasound is a simple, inexpensive, noninvasive, and dynamic modality for evaluating femoral cartilage (FC) thickness. This study aims to measure the FC thickness in knee osteoarthritis (OA) patients and compare it to healthy adults using ultrasound assessment. Methods An observational study with a cross-sectional design was conducted at the Department of Physical Medicine and Rehabilitation of Hajj General Hospital, Surabaya, Indonesia, from May to July 2022. Participants radiologically diagnosed with OA were included in the study and assigned to the OA group. Meanwhile, healthy adults without knee symptoms were included in the control group. FC thickness was measured using ultrasound scans at three sites: medial condyle (MC), intercondylar (IC), and lateral condyle (LC) on both sides of the knee. Results The mean age in the OA and control groups was 61.03 ± 8.6 and 33.93 ± 14.7 years, respectively. Most participants in both groups were female. The OA group exhibited a thinner FC (1.49-1.63 mm) than the control group (1.68-1.87 mm). There was a significant difference in the mean of the right and left MC in both groups (p < 0.05) but no significant difference in the IC and LC. Conclusion OA patients exhibited a thinner FC than healthy adults in the control group. There was a significant difference in the mean thickness of the MC between groups.
Collapse
|
4
|
Su J, Wan H, Pang Y, Lu Y, Liang J, Yan Z, Xu S, Sun T. Trans-Posterior Cruciate Ligament All-Inside Root Repair Versus Partial Meniscectomy for Medial Meniscus Posterior Root Tears: Comparison of Semiquantitative and Quantitative MRI Outcomes in Cartilage Degeneration and Osteoarthritic Progression. Cartilage 2022; 13:19476035221114242. [PMID: 35932104 PMCID: PMC9364209 DOI: 10.1177/19476035221114242] [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: 12/02/2022] Open
Abstract
OBJECTIVE To perform conventional, morphological, and T2 mapping compositional MRI imaging to assess the cartilage degeneration and osteoarthritic progression in patients with medial meniscus posterior root tears (MMPRTs) who underwent trans-posterior cruciate ligament (PCL) all-inside repair or partial meniscectomy. DESIGN Patients with MMPRTs after trans-PCL all-inside repair (group AR) or partial meniscectomy (group PM) between 2015 and 2018 were retrospectively identified. Preoperative and postoperative conventional MRI were collected to assess medial meniscus extrusion (MME) and the whole-organ magnetic resonance imaging score (WORMS). Postoperative morphological MRI and T2 mapping compositional MRI were collected to evaluate the quantitative cartilage thickness/volume and cartilage composition. RESULTS The final cohort consisted of 21 patients in group AR and 22 patients in group PM, with no differences in demographic data and baseline patient characteristics between the 2 groups. Group AR demonstrated less progression of articular cartilage wear (P < 0.05) and decreased meniscal extrusion (P = 0.008) than group PM at the final follow-up. In addition, group AR demonstrated less extracellular matrix degeneration in the cartilage subregion of the medial compartment (P < 0.05) than group PM with lower T2 relaxation times in the superficial layer of the articular cartilage. CONCLUSION Trans-PCL all-inside repair of MMPRTs could delay the initial cartilage deterioration and morphological cartilage degeneration compared with partial meniscectomy. However, the amount of residual meniscal extrusion is clinically important, and an improved root repair fixation method should be investigated.
Collapse
Affiliation(s)
- Jiarong Su
- Arthritis Clinic and Research Center,
Peking University People’s Hospital, Beijing, China
| | | | - Yingchang Pang
- Arthritis Clinic and Research Center,
Peking University People’s Hospital, Beijing, China
| | - Yanli Lu
- Beijing Longfu Hospital, Beijing,
China
| | - Jiaming Liang
- Arthritis Clinic and Research Center,
Peking University People’s Hospital, Beijing, China
| | | | - Sibo Xu
- Arthritis Clinic and Research Center,
Peking University People’s Hospital, Beijing, China
| | - Tiezheng Sun
- Arthritis Clinic and Research Center,
Peking University People’s Hospital, Beijing, China,Tiezheng Sun, Arthritis Clinic and Research
Center, Peking University People’s Hospital, 11 Xizhimen South Street, Xicheng
District, Beijing 100044, China.
| |
Collapse
|
5
|
Chechik Y, Beit Ner E, Lysyy O, Tal S, Stern N, Agar G, Beer Y, Ben-Eliezer N, Lindner D. Post-Run T 2 Mapping Changes in Knees of Adolescent Basketball Players. Cartilage 2021; 13:707S-717S. [PMID: 34128410 PMCID: PMC8808782 DOI: 10.1177/19476035211021891] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE While articular cartilage defects are common incidental findings among adult athletes, the effect of running on the cartilage of adolescent athletes have rarely been assessed. This study aims to assess the variations in the articular cartilage of the knees in healthy adolescent basketball players using quantitative T2 MRI (magnetic resonance imaging). DESIGN Fifteen adolescent basketball players were recruited (13.8 ± 0.5 years old). Girls were excluded to avoid potential gender-related confounding effects. Players underwent a pre-run MRI scan of both knees. All participants performed a 30-minute run on a treadmill. Within 15 minutes after completion of their run, players underwent a second, post-run MRI scan. Quantitative T2 maps were generated using the echo modulation curve (EMC) algorithm. Pre-run scans and post-run scans were compared using paired t test. RESULTS Participants finished their 30-minute run with a mean running distance of 5.77 ± 0.42 km. Pre-run scans analysis found statistically significant (P < 0.05) changes in 3 regions of the knee lateral compartment representing the cartilaginous tissue. No differences were found in the knee medial compartment. Post-run analysis showed lower T2 values in the medial compartment compared to the pre-run scans in several weight-bearing regions: femoral condyle central (pre/post mean values of 33.9/32.2 ms, P = 0.020); femoral condyle posterior (38.1/36.8 ms, P = 0.038); and tibial plateau posterior (34.1/31.0 ms, P < 0.001). The lateral regions did not show any significant changes. CONCLUSIONS Running leads to microstructural changes in the articular cartilage in several weight-bearing areas of the medial compartment, both in the femoral and the tibial cartilage.
Collapse
Affiliation(s)
- Yigal Chechik
- Department of Orthopedic Surgery,
Yitzhak Shamir Medical Center, Zerifin, Israel, affiliated to the Sackler Faculty of
Medicine, Tel Aviv University, Tel Aviv, Israel,Yigal Chechik, Department of Orthopedic
Surgery, Yitzhak Shamir Medical Center, Zerifin 70300, Israel.
| | - Eran Beit Ner
- Department of Orthopedic Surgery,
Yitzhak Shamir Medical Center, Zerifin, Israel, affiliated to the Sackler Faculty of
Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Oleg Lysyy
- Department of Imaging, Yitzhak Shamir
Medical Center, Zerifin, Israel, affiliated to the Sackler Faculty of Medicine,
Tel-Aviv University, Tel Aviv, Israel
| | - Sigal Tal
- Department of Imaging, Yitzhak Shamir
Medical Center, Zerifin, Israel, affiliated to the Sackler Faculty of Medicine,
Tel-Aviv University, Tel Aviv, Israel
| | - Neta Stern
- Department of Biomedical Engineering,
Tel Aviv University, Tel Aviv, Israel
| | - Gabriel Agar
- Department of Orthopedic Surgery,
Yitzhak Shamir Medical Center, Zerifin, Israel, affiliated to the Sackler Faculty of
Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yiftach Beer
- Department of Orthopedic Surgery,
Yitzhak Shamir Medical Center, Zerifin, Israel, affiliated to the Sackler Faculty of
Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Noam Ben-Eliezer
- Department of Biomedical Engineering,
Tel Aviv University, Tel Aviv, Israel,Sagol School of Neuroscience, Tel Aviv
University, Tel Aviv, Israel,Center for Advanced Imaging Innovation
and Research (CAI2R), New-York University Langone Medical Center, New York, NY,
USA
| | - Dror Lindner
- Department of Orthopedic Surgery,
Yitzhak Shamir Medical Center, Zerifin, Israel, affiliated to the Sackler Faculty of
Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
6
|
Longitudinal Femoral Cartilage T2 Relaxation Time and Thickness Changes with Fast Sequential Radiographic Progression of Medial Knee Osteoarthritis-Data from the Osteoarthritis Initiative (OAI). J Clin Med 2021; 10:jcm10061294. [PMID: 33801000 PMCID: PMC8003903 DOI: 10.3390/jcm10061294] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 03/12/2021] [Accepted: 03/17/2021] [Indexed: 11/24/2022] Open
Abstract
This study tested for longitudinal changes in femoral cartilage T2 relaxation time and thickness in fast-progressing medial femorotibial osteoarthritis (OA). From the Osteoarthritis Initiative (OAI) database, nineteen knees fulfilled the inclusion criteria, which included medial femorotibial OA and sequential progression from Kellgren–Lawrence grade (KL) 1 to KL2 to KL3 within five years. Median T2 value and mean thickness were calculated for six condylar volumes of interest (VOIs; medial/lateral anterior, central, posterior) and six sub-VOIs (medial/lateral anterior external, central, internal). T2 value and thickness changes between severity timepoints were tested using repeated statistics. T2 values increased between KL1 and KL2 and between KL1 and KL3 in the medial compartment (p ≤ 0.02), whereas both increases and decreases were observed between the same timepoints in the lateral compartment (p ≤ 0.02). Cartilage thickness decreased in VOI/subVOIs of the medial compartment from KL1 to KL2 and KL3 (p ≤ 0.014). Cartilage T2 value and thickness changes varied spatially over the femoral condyles. While all T2 changes occurred in the early radiographic stages of OA, thickness changes occurred primarily in the later stages. These data therefore support the use of T2 relaxation time analyses in methods of detecting disease-related change during early OA, a valuable period for therapeutic interventions.
Collapse
|
7
|
Si L, Xuan K, Zhong J, Huo J, Xing Y, Geng J, Hu Y, Zhang H, Wang Q, Yao W. Knee Cartilage Thickness Differs Alongside Ages: A 3-T Magnetic Resonance Research Upon 2,481 Subjects via Deep Learning. Front Med (Lausanne) 2021; 7:600049. [PMID: 33634142 PMCID: PMC7900571 DOI: 10.3389/fmed.2020.600049] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 12/30/2020] [Indexed: 12/21/2022] Open
Abstract
Background: It was difficult to distinguish the cartilage thinning of an entire knee joint and to track the evolution of cartilage morphology alongside ages in the general population, which was of great significance for studying osteoarthritis until big imaging data and artificial intelligence are fused. The purposes of our study are (1) to explore the cartilage thickness in anatomical regions of the knee joint among a large collection of healthy knees, and (2) to investigate the relationship between the thinning pattern of the cartilages and the increasing ages. Methods: In this retrospective study, 2,481 healthy knees (subjects ranging from 15 to 64 years old, mean age: 35 ± 10 years) were recruited. With magnetic resonance images of knees acquired on a 3-T superconducting scanner, we automatically and precisely segmented the cartilage via deep learning and calculated the cartilage thickness in 14 anatomical regions. The thickness readings were compared using ANOVA by considering the factors of age, sex, and side. We further tracked the relationship between the thinning pattern of the cartilage thickness and the increasing ages by regression analysis. Results: The cartilage thickness was always thicker in the femur than corresponding regions in the tibia (p < 0.05). Regression analysis suggested cartilage thinning alongside ages in all regions (p < 0.05) except for medial and lateral anterior tibia in both females and males (p > 0.05). The thinning speed of men was faster than women in medial anterior and lateral anterior femur, yet slower in the medial patella (p < 0.05). Conclusion: We established the calculation method of cartilage thickness using big data and deep learning. We demonstrated that cartilage thickness differed across individual regions in the knee joint. Cartilage thinning alongside ages was identified, and the thinning pattern was consistent in the tibia while inconsistent in patellar and femoral between sexes. These findings provide a potential reference to detect cartilage anomaly.
Collapse
Affiliation(s)
- Liping Si
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Kai Xuan
- Institute for Medical Imaging Technology, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Jingyu Zhong
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiayu Huo
- Institute for Medical Imaging Technology, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Yue Xing
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jia Geng
- Department of Radiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Yangfan Hu
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Huan Zhang
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qian Wang
- Institute for Medical Imaging Technology, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Weiwu Yao
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| |
Collapse
|
8
|
Pastor T, Fröhlich S, Spörri J, Schreiber T, Schweizer A. Cartilage abnormalities and osteophytes in the fingers of elite sport climbers: An ultrasonography-based cross-sectional study. Eur J Sport Sci 2019; 20:269-276. [DOI: 10.1080/17461391.2019.1631389] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Torsten Pastor
- Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Stefan Fröhlich
- Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Jörg Spörri
- Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Tonja Schreiber
- Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Andreas Schweizer
- Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| |
Collapse
|
9
|
Osteoarthritis year in review 2018: imaging. Osteoarthritis Cartilage 2019; 27:401-411. [PMID: 30590194 DOI: 10.1016/j.joca.2018.12.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 12/10/2018] [Accepted: 12/17/2018] [Indexed: 02/02/2023]
Abstract
PURPOSE To provide a narrative review of the most relevant original research published in 2017/2018 on osteoarthritis imaging. METHODS The PubMed database was used to recover all relevant articles pertaining to osteoarthritis and medical imaging published between 1 April 2017 and 31 March 2018. Review articles, case studies and in vitro or animal studies were excluded. The original publications were subjectively sorted based on relevance, novelty and impact. RESULTS AND CONCLUSIONS The publication search yielded 1,155 references. In the assessed publications, the most common imaging modalities were radiography (N = 708) and magnetic resonance imaging (MRI) (355), followed by computed tomography (CT) (220), ultrasound (85) and nuclear medicine (17). An overview of the most important publications to the osteoarthritis (OA) research community is presented in this narrative review. Imaging studies play an increasingly important role in OA research, and have helped us to understand better the pathophysiology of OA. Radiography and MRI continue to be the most applied imaging modalities, while quantitative MRI methods and texture analysis are becoming more popular. The value of ultrasound in OA research has been demonstrated. Several multi-modality predictive models have been developed. Deep learning has potential for more automatic and standardized analyses in future OA imaging research.
Collapse
|