Development of a Comprehensive Osteochondral Allograft MRI Scoring System (OCAMRISS) With Histopathologic, Micro-Computed Tomography, and Biomechanical Validation

被引:42
作者
Chang, Eric Y. [1 ,2 ]
Pallante-Kichura, Andrea L. [3 ]
Bae, Won C. [2 ]
Du, Jiang [2 ]
Statum, Sheronda [2 ]
Wolfson, Tanya [2 ]
Gamst, Anthony C. [2 ]
Cory, Esther [3 ]
Amiel, David [4 ]
Bugbee, William D. [4 ,5 ]
Sah, Robert L. [3 ,4 ]
Chung, Christine B. [1 ,2 ]
机构
[1] VA San Diego Healthcare Syst, Dept Radiol, San Diego, CA USA
[2] Univ Calif San Diego, Dept Radiol, San Diego Med Ctr, La Jolla, CA 92093 USA
[3] Univ Calif San Diego, Dept Bioengn, San Diego, CA 92103 USA
[4] Univ Calif San Diego, San Diego Sch Med, Dept Orthopaed Surg, San Diego, CA 92103 USA
[5] Scripps Clin, Dept Orthopaed Surg, La Jolla, CA 92037 USA
基金
美国国家卫生研究院;
关键词
cartilage repair; osteochondral allografts; MRI scoring system; AUTOLOGOUS CHONDROCYTE IMPLANTATION; ARTICULAR-CARTILAGE REPAIR; FULL-THICKNESS DEFECTS; BONE-MARROW EDEMA; TERM-FOLLOW-UP; KNEE-JOINT; OSTEOARTICULAR ALLOGRAFTS; OSTEOARTHRITIC KNEES; MENISCAL TEARS; MODEL;
D O I
10.1177/1947603513514436
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Objective: To describe and apply a semiquantitative MRI scoring system for multifeature analysis of cartilage defect repair in the knee by osteochondral allografts and to correlate this scoring system with histopathologic, micro-computed tomography (mu CT), and biomechanical reference standards using a goat repair model. Design: Fourteen adult goats had 2 osteochondral allografts implanted into each knee: one in the medial femoral condyle and one in the lateral trochlea. At 12 months, goats were euthanized and MRI was performed. Two blinded radiologists independently rated 9 primary features for each graft, including cartilage signal, fill, edge integration, surface congruity, calcified cartilage integrity, subchondral bone plate congruity, subchondral bone marrow signal, osseous integration, and presence of cystic changes. Four ancillary features of the joint were also evaluated, including opposing cartilage, meniscal tears, synovitis, and fat-pad scarring. Comparison was made with histologic and mu CT reference standards as well as biomechanical measures. Interobserver agreement and agreement with reference standards was assessed. Cohen's kappa Spearman's correlation, and Kruskal-Wallis tests were used as appropriate. Results: There was substantial agreement (kappa > 0.6, P < 0.001) for each MRI feature and with comparison against reference standards, except for cartilage edge integration (kappa = 0.6). There was a strong positive correlation between MRI and reference standard scores (rho = 0.86, P < 0.01). Osteochondral allograft MRI scoring system was sensitive to differences in outcomes between the types of allografts. Conclusions: We have described a comprehensive MRI scoring system for osteochondral allografts and have validated this scoring system with histopathologic and mu CT reference standards as well as biomechanical indentation testing.
引用
收藏
页码:16 / 27
页数:12
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