ABSTRACT
OBJECTIVE: To describe the MR appearance following autogenous osteochondral "plug" transfer for the treatment of focal chondral defects of the knee. DESIGN AND PATIENTS: Twenty-nine 1.5-T MR knee studies including dynamic gadolinium enhancement were performed on 21 patients following autogenous osteochondral "plug" transfer. Three musculoskeletal radiologists retrospectively reviewed images to evaluate graft and donor site appearance and MR findings were correlated with clinical outcomes. RESULTS: MR images demonstrated graft protuberance (n=12/21; range 1-2 mm), depression (n=2/21; range 1 mm), and surface incongruity: mild (n=17/21), moderate (n=2/21), marked (n=1/21). The T2 signal of graft cartilage was similar to that of adjacent cartilage in 25 of 29 examinations, and increased in four. Graft cartilage thickness relative to adjacent cartilage was <50% in six patients, 50-100% in 15. Graft enhancement in bone was absent at 2 weeks, but present at between 4 and 6 weeks following surgery. All patients had clinical follow-up examinations and knee outcome survey scores were obtained in 15 patients with follow-up greater than 3 months after surgery. All patients demonstrated the expected short-term progressive clinical improvement. CONCLUSION: MR images reveal a wide range of appearances following osteochondral "plug" transfer. Minor variations in graft orientation and surface congruity do not result in adverse clinical outcome in the short term.
Subject(s)
Cartilage, Articular/injuries , Cartilage, Articular/surgery , Knee Injuries/surgery , Magnetic Resonance Imaging , Adult , Bone Transplantation , Female , Follow-Up Studies , Humans , Male , Time Factors , Transplantation, AutologousABSTRACT
SUMMARY: Seven months after a quadrupled semitendinosus anterior cruciate ligament reconstruction, a 44-year-old active-duty soldier reported symptoms consistent with a medial meniscus tear. Preoperative magnetic resonance imaging showed an intra-articular bioabsorbable interference screw within his intercondylar notch. The screw was retrieved arthroscopically. The graft was intact and functional except for a small portion of the anterior fibers, which were debrided. The patient returned to full activities without complaints.
Subject(s)
Absorbable Implants , Anterior Cruciate Ligament/surgery , Bone Screws , Tibial Meniscus Injuries , Adult , Diagnosis, Differential , Humans , Magnetic Resonance Imaging , Male , Menisci, Tibial/pathologySubject(s)
Amyloidosis/complications , Hip Joint , Joint Diseases/etiology , Amyloidosis/diagnosis , Amyloidosis/etiology , Hip Joint/diagnostic imaging , Humans , Joint Diseases/diagnosis , Joint Diseases/diagnostic imaging , Magnetic Resonance Imaging , Male , Middle Aged , Radiography , Renal Dialysis/adverse effectsABSTRACT
Artifact reduction is fundamental to the daily clinical application of magnetic resonance (MR) imaging. Imaging of the postoperative patient may be difficult because of surgically introduced materials that result in artifacts. The authors tested some commonly used types of surgical suture for MR susceptibility artifact with various imaging sequences. Ten different suture types were studied. Suture was immersed in vegetable oil in separate plastic test tubes. The sutures were also studied embedded in meat. All samples were studied with T1-weighted and T2-weighted spin-echo, STIR (short-inversion-time inversion-recovery), and two-dimensional and three-dimensional gradient-echo sequences. Silk suture produced the most artifact.
