Relationship Between Bone Marrow Lesions on MRI and Cartilage Degeneration in Osteochondral Lesions of the Talar Dome

Background: In the evaluation of osteochondral lesions of the talar dome (OLT), bone marrow lesions (BML) are commonly observed in the subchondral bone on magnetic resonance imaging (MRI). However, the significance of BML, such as the histology of the overlying cartilage, is still unclear. The purpose of this study was to investigate the relationship between the BML and cartilage degeneration in OLT. Methods: Thirty-three ankles with OLT were included in this study. All ankles underwent CT and MRI and had operative treatment. The ankles were divided into 2 groups, depending on the presence of bone sclerosis (ie, with or without) in the host bone just below the osteochondral fragment (nonsclerosis group and sclerosis group). The area of BML was compared between the 2 groups. Biopsies of the osteochondral fragment from 20 ankles were performed during surgery, and the correlation between the BML and cartilage degeneration was analyzed. The remaining 13 ankles had the CT and MRI compared with the arthroscopic findings. Results: The mean area of BML in the nonsclerosis group was significantly larger than that in the sclerosis group. In the histologic analysis, there was a significant and moderate correlation between the Mankin score and the area of BML. The mean Mankin score in the nonsclerosis group was significantly lower than that in the sclerosis group. Conclusions: This study revealed that a large area of BML on MRI exhibited low degeneration of cartilage of the osteochondral fragment, while a small area of BML indicated sclerosis of the subchondral bone with severe degeneration of cartilage. The evaluation of BML may predict the cartilage condition of the osteochondral fragment. Level of Evidence: Level III, comparative series.

[1]  N. Adachi,et al.  Added Value of Preoperative Computed Tomography for Determining Cartilage Degeneration in Patients With Osteochondral Lesions of the Talar Dome , 2018, The American journal of sports medicine.

[2]  S. Stufkens,et al.  Reply to the letter to the editor: comment on “No superior treatment for primary osteochondral defects of the talus” , 2017, Knee Surgery, Sports Traumatology, Arthroscopy.

[3]  S. Stufkens,et al.  No superior treatment for primary osteochondral defects of the talus , 2017, Knee Surgery, Sports Traumatology, Arthroscopy.

[4]  J. Reseland,et al.  Bone marrow lesions in hip osteoarthritis are characterized by increased bone turnover and enhanced angiogenesis. , 2016, Osteoarthritis and cartilage.

[5]  M. Marcacci,et al.  Aetiology and pathogenesis of bone marrow lesions and osteonecrosis of the knee , 2016, EFORT open reviews.

[6]  J. Farr,et al.  Bone marrow lesions and subchondral bone pathology of the knee , 2016, Knee Surgery, Sports Traumatology, Arthroscopy.

[7]  F. Cicuttini,et al.  Bone marrow lesions detected by specific combination of MRI sequences are associated with severity of osteochondral degeneration , 2016, Arthritis Research & Therapy.

[8]  N. Adachi,et al.  Appearance of Subchondral Bone in Computed Tomography Is Related to Cartilage Damage in Osteochondral Lesions of the Talar Dome , 2014, Foot & ankle international.

[9]  W A Kalender,et al.  Bone marrow lesions identified by MRI in knee osteoarthritis are associated with locally increased bone mineral density measured by QCT. , 2013, Osteoarthritis and cartilage.

[10]  Kazuki Kanazawa,et al.  Arthroscopic Bone Marrow Stimulation Techniques for Osteochondral Lesions of the Talus , 2013, The American journal of sports medicine.

[11]  Nae-jung Rim,et al.  Comparison of Arthroscopic and Magnetic Resonance Imaging Findings in Osteochondral Lesions of the Talus , 2012, Foot & ankle international.

[12]  M. Zengerink,et al.  Osteochondral defects in the ankle: why painful? , 2010, Knee Surgery, Sports Traumatology, Arthroscopy.

[13]  E. Itoi,et al.  Histologic Findings and Possible Causes of Osteochondritis Dissecans of the Knee , 2009, The American journal of sports medicine.

[14]  A Guermazi,et al.  MRI-detected subchondral bone marrow signal alterations of the knee joint: terminology, imaging appearance, relevance and radiological differential diagnosis. , 2009, Osteoarthritis and cartilage.

[15]  B. Morrey.  Arthroscopic Treatment of Chronic Osteochondral Lesions of the Talus: Long-term Results , 2009 .

[16]  J. Raynauld,et al.  Temporal assessment of bone marrow lesions on magnetic resonance imaging in a canine model of knee osteoarthritis: impact of sequence selection. , 2008, Osteoarthritis and cartilage.

[17]  N. Kettner,et al.  Bone marrow edema: pathophysiology, differential diagnosis, and imaging , 2008, Acta radiologica.

[18]  Xiaojuan Li,et al.  Diagnostic performance of in vivo 3-T MRI for articular cartilage abnormalities in human osteoarthritic knees using histology as standard of reference , 2008, European Radiology.

[19]  S. Raikin,et al.  Osteochondral Lesions of the Talus: Localization and Morphologic Data from 424 Patients Using a Novel Anatomical Grid Scheme , 2007, Foot & ankle international.

[20]  R. Ferkel,et al.  Current concepts: treatment of osteochondral ankle defects. , 2006, Foot and ankle clinics.

[21]  J. Carrino,et al.  High-signal T2 changes of the bone marrow of the foot and ankle in children: red marrow or traumatic changes? , 2006, Pediatric Radiology.

[22]  J. Fine,et al.  Subchondral bone marrow edema in patients with degeneration of the articular cartilage of the knee joint. , 2006, Radiology.

[23]  M. Dijkgraaf,et al.  Prospective study on diagnostic strategies in osteochondral lesions of the talus. Is MRI superior to helical CT? , 2005, The Journal of bone and joint surgery. British volume.

[24]  C. Hayes,et al.  Magnetic resonance-detected subchondral bone marrow and cartilage defect characteristics associated with pain and X-ray-defined knee osteoarthritis. , 2003, Osteoarthritis and cartilage.

[25]  M. Brittberg,et al.  Evaluation of Cartilage Injuries and Repair , 2003, The Journal of bone and joint surgery. American volume.

[26]  Sharmila Majumdar,et al.  Osteoarthritis: MR imaging findings in different stages of disease and correlation with clinical findings. , 2003, Radiology.

[27]  H J Mankin,et al.  Articular cartilage: degeneration and osteoarthritis, repair, regeneration, and transplantation. , 1998, Instructional course lectures.

[28]  B. Graf,et al.  Reassessment of the MR criteria for stability of osteochondritis dissecans in the knee and ankle , 1996, Skeletal Radiology.

[29]  R. Rose,et al.  Role of Subchondral Bone in the Initiation and Progression of Cartilage Damage , 1986, Clinical orthopaedics and related research.

[30]  H. Mankin,et al.  Biochemical and metabolic abnormalities in articular cartilage from osteoarthritic human hips. III. Distribution and metabolism of amino sugar-containing macromolecules. , 1981, The Journal of bone and joint surgery. American volume.

[31]  H. Dorfman,et al.  Biochemical and metabolic abnormalities in articular cartilage from osteo-arthritic human hips. II. Correlation of morphology with biochemical and metabolic data. , 1971, The Journal of bone and joint surgery. American volume.