Cartilage morphology and T1ρ and T2 quantification in ACL-reconstructed knees: a 2-year follow-up.

OBJECTIVE To describe cartilage matrix and morphology changes, assessed using quantitative magnetic resonance imaging (MRI), after acute anterior cruciate ligament (ACL) injury relative to controls and longitudinally during 2 years following reconstruction. METHOD Fifteen patients with acute ACL injuries and 16 healthy volunteers with a similar demographic profile but no history of osteoarthritis or knee injury were studied. The injured knee of each participant was imaged with a 3.0 T MR scanner at baseline (prior to ACL reconstruction); patients' knees were re-imaged 1 and 2 years after ACL reconstruction. Cartilage T1ρ and T2 values in full thickness, superficial layers, and deep layers, and cartilage thickness of the full layer were quantified within subcompartments of the knee joint. RESULTS In the posterolateral tibial cartilage, T1ρ values were significantly higher in ACL-injured knees than control knees at baseline and were not fully recovered 2 after ACL reconstruction. T1ρ values of medial tibiofemoral cartilage in ACL-injured knees increased over the 2-year study and were significantly elevated compared to that of the control knees. T2 values in cartilage of the central aspect of the medial femoral condyle at the 2-year follow-up were significantly elevated compared with control knees. Cartilage in the posterior regions of the lateral tibia was significantly thinner, while cartilage in the central aspect of the medial femur was significantly thicker than that of controls. Patients with lesions in the posterior horn of the medial meniscus exhibited significantly higher T1ρ values in weight-bearing regions of the tibiofemoral cartilage than that of control subjects over the 2-year period, whereas patients without medial meniscal tears did not. CONCLUSION Quantitative MRI provides powerful in vivo tools to quantitatively evaluate early changes of cartilage matrix and morphology after acute ACL injury and reconstruction, which may possibly relate to the development of post-traumatic osteoarthritis in such joints.

[1]  Felix Eckstein,et al.  Quantitative MRI of cartilage and bone: degenerative changes in osteoarthritis , 2006, NMR in biomedicine.

[2]  Sharmila Majumdar,et al.  Quantitative assessment of bone marrow edema‐like lesion and overlying cartilage in knees with osteoarthritis and anterior cruciate ligament tear using MR imaging and spectroscopic imaging at 3 Tesla , 2008, Journal of magnetic resonance imaging : JMRI.

[3]  Sharmila Majumdar,et al.  Magnetic resonance imaging of 3-dimensional in vivo tibiofemoral kinematics in anterior cruciate ligament-reconstructed knees. , 2009, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[4]  Sharmila Majumdar,et al.  Cartilage in anterior cruciate ligament-reconstructed knees: MR imaging T1{rho} and T2--initial experience with 1-year follow-up. , 2011, Radiology.

[5]  J. B. Kneeland,et al.  T1ρ‐relaxation in articular cartilage: Effects of enzymatic degradation , 1997, Magnetic resonance in medicine.

[6]  M. Englund,et al.  High prevalence of knee osteoarthritis, pain, and functional limitations in female soccer players twelve years after anterior cruciate ligament injury. , 2004, Arthritis and rheumatism.

[7]  L. Snyder-Mackler,et al.  Fate of the ACL-injured patient: a prospective outcome study. , 1995, The American journal of sports medicine.

[8]  C. Hayes,et al.  Mechanism-based pattern approach to classification of complex injuries of the knee depicted at MR imaging. , 2000, Radiographics : a review publication of the Radiological Society of North America, Inc.

[9]  D. Nikolić.  Lateral meniscal tears and their evolution in acute injuries of the anterior cruciate ligament of the knee Arthroscopic analysis , 1998, Knee Surgery, Sports Traumatology, Arthroscopy.

[10]  D. Burstein,et al.  Gd‐DTPA2− as a measure of cartilage degradation , 1996, Magnetic resonance in medicine.

[11]  S Majumdar,et al.  In vivo T(1rho) and T(2) mapping of articular cartilage in osteoarthritis of the knee using 3 T MRI. , 2007, Osteoarthritis and cartilage.

[12]  Thomas M. Link,et al.  Inter-subject comparison of MRI knee cartilage thickness , 2008, Medical Image Anal..

[13]  B. Morrey.  Cartilage Injury After Acute, Isolated Anterior Cruciate Ligament Tear: Immediate and Longitudinal Effect With Clinical/MRI Follow-up , 2012 .

[14]  S. Majumdar,et al.  New techniques for cartilage magnetic resonance imaging relaxation time analysis: Texture analysis of flattened cartilage and localized intra‐ and inter‐subject comparisons , 2008, Magnetic resonance in medicine.

[15]  Arijitt Borthakur,et al.  Proteoglycan depletion-induced changes in transverse relaxation maps of cartilage: comparison of T2 and T1rho. , 2002, Academic radiology.

[16]  L. White,et al.  Quantitative MR imaging evaluation of the cartilage thickness and subchondral bone area in patients with ACL-reconstructions 7 years after surgery. , 2009, Osteoarthritis and cartilage.

[17]  E. Roos,et al.  The Long-term Consequence of Anterior Cruciate Ligament and Meniscus Injuries , 2007, The American journal of sports medicine.

[18]  J. Kellgren,et al.  Radiological Assessment of Osteo-Arthrosis , 1957, Annals of the rheumatic diseases.

[19]  A Guermazi,et al.  The association of meniscal pathologic changes with cartilage loss in symptomatic knee osteoarthritis. , 2006, Arthritis and rheumatism.

[20]  H C Charles,et al.  Subregional femorotibial cartilage morphology in women--comparison between healthy controls and participants with different grades of radiographic knee osteoarthritis. , 2009, Osteoarthritis and cartilage.

[21]  J. Svensson,et al.  Longitudinal assessment of femoral knee cartilage quality using contrast enhanced MRI (dGEMRIC) in patients with anterior cruciate ligament injury--comparison with asymptomatic volunteers. , 2011, Osteoarthritis and cartilage.

[22]  Kathryn M Refshauge,et al.  Comparison of kinematics in the healthy and ACL injured knee using MRI. , 2005, Journal of biomechanics.

[23]  H. Genant,et al.  Whole-Organ Magnetic Resonance Imaging Score (WORMS) of the knee in osteoarthritis. , 2004, Osteoarthritis and cartilage.

[24]  Xiaojuan Li,et al.  Detection of posttraumatic cartilage injury using quantitative T1rho magnetic resonance imaging. A report of two cases with arthroscopic findings. , 2006, The Journal of bone and joint surgery. American volume.

[25]  Xiaojuan Li,et al.  In Vivo T1&rgr; Quantitative Assessment of Knee Cartilage After Anterior Cruciate Ligament Injury Using 3 Tesla Magnetic Resonance Imaging , 2008, Investigative radiology.

[26]  S. Majumdar,et al.  T2 relaxation time of cartilage at MR imaging: comparison with severity of knee osteoarthritis. , 2004, Radiology.

[27]  Sharmila Majumdar,et al.  T2 relaxation time measurements in osteoarthritis. , 2004, Magnetic resonance imaging.

[28]  Bryan T. Hanypsiak,et al.  Twelve-Year Follow-up on Anterior Cruciate Ligament Reconstruction , 2008, The American journal of sports medicine.

[29]  Xiaojuan Li,et al.  Longitudinal assessment of bone marrow edema-like lesions and cartilage degeneration in osteoarthritis using 3 T MR T1rho quantification , 2010, Skeletal Radiology.

[30]  E. Roos,et al.  High prevalence of osteoarthritis 14 years after an anterior cruciate ligament tear in male soccer players: a study of radiographic and patient relevant outcomes , 2004, Annals of the rheumatic diseases.

[31]  F. Nyquist,et al.  Cartilage glycosaminoglycan loss in the acute phase after an anterior cruciate ligament injury: delayed gadolinium-enhanced magnetic resonance imaging of cartilage and synovial fluid analysis. , 2005, Arthritis and rheumatism.

[32]  T. Patt,et al.  The occurrence of osteoarthritis at a minimum of ten years after reconstruction of the anterior cruciate ligament , 2008, Journal of Orthopaedic Surgery and Research.

[33]  I. Kiviranta,et al.  Delayed gadolinium‐enhanced MRI of cartilage (dGEMRIC) and T2 characteristics of human knee articular cartilage: Topographical variation and relationships to mechanical properties , 2004, Magnetic resonance in medicine.

[34]  Thomas P Andriacchi,et al.  Knee kinematics, cartilage morphology, and osteoarthritis after ACL injury. , 2008, Medicine and science in sports and exercise.

[35]  H. Roos,et al.  Osteoarthritis of the knee after injury to the anterior cruciate ligament or meniscus: the influence of time and age. , 1995, Osteoarthritis and cartilage.

[36]  R. Frobell,et al.  Change in cartilage thickness, posttraumatic bone marrow lesions, and joint fluid volumes after acute ACL disruption: a two-year prospective MRI study of sixty-one subjects. , 2011, The Journal of bone and joint surgery. American volume.

[37]  Harry E Rubash,et al.  The cartilage thickness distribution in the tibiofemoral joint and its correlation with cartilage-to-cartilage contact. , 2005, Clinical biomechanics.

[38]  T J Mosher,et al.  Human articular cartilage: influence of aging and early symptomatic degeneration on the spatial variation of T2--preliminary findings at 3 T. , 2000, Radiology.

[39]  J. S. Keene,et al.  "Bone bruises" on magnetic resonance imaging evaluation of anterior cruciate ligament injuries , 1993, The American journal of sports medicine.

[40]  Freddie H. Fu,et al.  Current Concepts Current Trends in Anterior Cruciate Ligament Reconstruction Part II . Operative Procedures and Clinical Correlations , 2015 .

[41]  L. D. de Bont,et al.  The structure, biochemistry, and metabolism of osteoarthritic cartilage: a review of the literature. , 1995, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.