Rebecca Moyer1,2, Trevor Birmingham3,4,5, Felix Eckstein6,7, Wolfgang Wirth6,7, Susanne Maschek6,7, Blaine Chronik8, J Robert Giffin9,10,11. 1. Faculty of Health, School of Physiotherapy, Dalhousie University, 5869 University Ave, Forrest Building, PO Box 15000, Halifax, NS, B3H 4R2, Canada. rebecca.moyer@dal.ca. 2. Bone and Joint Institute, Western University, London, ON, Canada. rebecca.moyer@dal.ca. 3. Wolf Orthopaedic Biomechanics Laboratory, Fowler Kennedy Sport Medicine Clinic, Western University, London, ON, Canada. tbirming@uwo.ca. 4. Bone and Joint Institute, Western University, London, ON, Canada. tbirming@uwo.ca. 5. Faculty of Health Sciences, School of Physical Therapy, Western University, London, ON, Canada. tbirming@uwo.ca. 6. Institute of Anatomy, Paracelsus Medical University Salzburg and Nuremberg, Salzburg, Austria. 7. Chondrometrics GmbH, Ainring, Germany. 8. The xMR Labs, Department of Physics and Astronomy, Western University, London, ON, Canada. 9. Wolf Orthopaedic Biomechanics Laboratory, Fowler Kennedy Sport Medicine Clinic, Western University, London, ON, Canada. 10. Bone and Joint Institute, Western University, London, ON, Canada. 11. Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Abstract
OBJECTIVES: To test PEEK implant-associated MRI artifacts, a method for blinding MRI readers, the repeatability of cartilage thickness measures before and 6 weeks after high tibial osteotomy (HTO), and the sensitivity to change of cartilage thickness 12 months after HTO. MATERIALS AND METHODS: Ten patients underwent HTO using a PEEK implant and 3 T-MRI before, 6 weeks and 12 months after surgery. Masks were applied to hide implant visibility on 48 MRI pairs, which were assessed by 7 readers (blinded to time). One blinded reader measured femorotibial cartilage thickness from masked MRIs. RESULTS: No artifacts were produced. Readers were unable to identify scans by time greater than by chance. Cartilage thickness before and 6 weeks after surgery was not significantly different and indicated excellent repeatability. Medial cartilage thickness increases 12 M postoperatively approached statistical significance (p = 0.06), with no lateral changes observed. Half of the participants had an increase in medial cartilage thickness at 12 M that exceeded the minimal detectable change. Standardized response mean values were moderate-to-large. DISCUSSION: Postoperative measures of cartilage thickness are repeatable, consistent and sensitive to change when artifact is eliminated, and a validated blinding technique is used. These results provide proof of concept for accurately measuring increases in medial knee articular cartilage after medial opening wedge HTO.
OBJECTIVES: To test PEEK implant-associated MRI artifacts, a method for blinding MRI readers, the repeatability of cartilage thickness measures before and 6 weeks after high tibial osteotomy (HTO), and the sensitivity to change of cartilage thickness 12 months after HTO. MATERIALS AND METHODS: Ten patients underwent HTO using a PEEK implant and 3 T-MRI before, 6 weeks and 12 months after surgery. Masks were applied to hide implant visibility on 48 MRI pairs, which were assessed by 7 readers (blinded to time). One blinded reader measured femorotibial cartilage thickness from masked MRIs. RESULTS: No artifacts were produced. Readers were unable to identify scans by time greater than by chance. Cartilage thickness before and 6 weeks after surgery was not significantly different and indicated excellent repeatability. Medial cartilage thickness increases 12 M postoperatively approached statistical significance (p = 0.06), with no lateral changes observed. Half of the participants had an increase in medial cartilage thickness at 12 M that exceeded the minimal detectable change. Standardized response mean values were moderate-to-large. DISCUSSION: Postoperative measures of cartilage thickness are repeatable, consistent and sensitive to change when artifact is eliminated, and a validated blinding technique is used. These results provide proof of concept for accurately measuring increases in medial knee articular cartilage after medial opening wedge HTO.
Entities:
Keywords:
Articular cartilage; Knee; Magnetic resonance imaging; Osteoarthritis; Osteotomy
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