D S Evangelopoulos1,2, M Huesler1, S S Ahmad1, E Aghayev3, M Neukamp3, C Röder3, A Exadaktylos4, H Bonel5, S Kohl1. 1. 1 Department of Orthopaedic Surgery, Inselspital, University of Bern, Bern, Switzerland. 2. 2 3rd Department of Orthopaedic Surgery, KAT Hospital, University of Athens, Greece. 3. 3 Institute for Evaluative Research in Orthopaedic Surgery, University of Bern, Bern, Switzerland. 4. 4 Department of Emergency Medicine, University of Bern, Bern, Switzerland. 5. 5 Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, University of Bern, Bern, Switzerland.
Abstract
OBJECTIVE: Arthroscopy is "the gold standard" for the diagnosis of knee cartilage lesions. However, it is invasive and expensive, and displays all the potential complications of an open surgical procedure. Ultra-high-field MRI now offers good opportunities for the indirect assessment of the integrity and structural changes of joint cartilage of the knee. The goal of the present study is to determine the site of early cartilaginous lesions in adults with non-traumatic knee pain. METHODS: 3-T MRI examinations of 200 asymptomatic knees with standard and three-dimensional double-echo steady-state (3D-DESS) cartilage-specific sequences were prospectively studied for early degenerative lesions of the tibiofemoral joint. Lesions were classified and mapped using the modified Outerbridge and modified International Cartilage Repair Society classifications. RESULTS: A total of 1437 lesions were detected: 56.1% grade I, 33.5% grade II, 7.2% grade III and 3.3% grade IV. Cartographically, grade I lesions were most common in the anteromedial tibial areas; grade II lesions in the anteromedial L5 femoral areas; and grade III in the centromedial M2 femoral areas. CONCLUSION: 3-T MRI with standard and 3D-DESS cartilage-specific sequences demonstrated that areas predisposed to early osteoarthritis are the central, lateral and ventromedial tibial plateau, as well as the central and medial femoral condyle. ADVANCES IN KNOWLEDGE: In contrast with previous studies reporting early cartilaginous lesions in the medial tibial compartment and/or in the medial femoral condyle, this study demonstrates that, regardless of grade, lesions preferentially occur at the L5 and M4 tibial and L5 and L2 femoral areas of the knee joint.
OBJECTIVE: Arthroscopy is "the gold standard" for the diagnosis of knee cartilage lesions. However, it is invasive and expensive, and displays all the potential complications of an open surgical procedure. Ultra-high-field MRI now offers good opportunities for the indirect assessment of the integrity and structural changes of joint cartilage of the knee. The goal of the present study is to determine the site of early cartilaginous lesions in adults with non-traumatic knee pain. METHODS: 3-T MRI examinations of 200 asymptomatic knees with standard and three-dimensional double-echo steady-state (3D-DESS) cartilage-specific sequences were prospectively studied for early degenerative lesions of the tibiofemoral joint. Lesions were classified and mapped using the modified Outerbridge and modified International Cartilage Repair Society classifications. RESULTS: A total of 1437 lesions were detected: 56.1% grade I, 33.5% grade II, 7.2% grade III and 3.3% grade IV. Cartographically, grade I lesions were most common in the anteromedial tibial areas; grade II lesions in the anteromedial L5 femoral areas; and grade III in the centromedial M2 femoral areas. CONCLUSION: 3-T MRI with standard and 3D-DESS cartilage-specific sequences demonstrated that areas predisposed to early osteoarthritis are the central, lateral and ventromedial tibial plateau, as well as the central and medial femoral condyle. ADVANCES IN KNOWLEDGE: In contrast with previous studies reporting early cartilaginous lesions in the medial tibial compartment and/or in the medial femoral condyle, this study demonstrates that, regardless of grade, lesions preferentially occur at the L5 and M4 tibial and L5 and L2 femoral areas of the knee joint.
Authors: Sabine Weckbach; Thomas Mendlik; Wilhelm Horger; Susi Wagner; Maximilian F Reiser; Christian Glaser Journal: Invest Radiol Date: 2006-02 Impact factor: 6.016
Authors: B Friemert; Y Oberländer; W Schwarz; H J Häberle; W Bähren; H Gerngross; B Danz Journal: Knee Surg Sports Traumatol Arthrosc Date: 2003-08-05 Impact factor: 4.342
Authors: Gregor Reisig; Michael Kreinest; Wiltrud Richter; Mechthild Wagner-Ecker; Dietmar Dinter; Ulrike Attenberger; Barbara Schneider-Wald; Stefan Fickert; Markus L Schwarz Journal: PLoS One Date: 2016-11-07 Impact factor: 3.240