Clinical optical coherence tomography of early articular cartilage degeneration in patients with degenerative meniscal tears.
OBJECTIVE
Quantitative and nondestructive methods for clinical diagnosis and staging of articular cartilage degeneration are important to the evaluation of potential disease-modifying treatments in osteoarthritis (OA). Optical coherence tomography (OCT) is a novel imaging technology that can generate microscopic-resolution cross-sectional images of articular cartilage in near real-time. This study tested the hypotheses that OCT can be used clinically to identify early cartilage degeneration and that OCT findings correlate with magnetic resonance imaging (MRI) T2 values and arthroscopy results.


METHODS
Patients undergoing arthroscopy for degenerative meniscal tears were recruited under Institutional Review Board-approved protocols. Thirty consecutive subjects completing preoperative 3.0T MRI, arthroscopy, and intraoperative OCT comprised the study group. Qualitative and quantitative OCT results and MRI T2 values were compared with modified Outerbridge cartilage degeneration scores (0-4 scale) assigned at arthroscopy.


RESULTS
Arthroscopic grades showed cartilage abnormality in 23 of the 30 patients. OCT grades were abnormal in 28 of the 30 patients. Both qualitative and quantitative OCT strongly correlated with the arthroscopy results (P = 0.004 and P = 0.0002, respectively, by Kruskal-Wallis test). Neither the superficial nor the deep cartilage T2 values correlated with the arthroscopy results. The quantitative OCT results correlated with the T2 values in the superficial cartilage (Pearson's r = 0.39, P = 0.03).


CONCLUSIONS
These data show that OCT can be used clinically to provide qualitative and quantitative assessments of early articular cartilage degeneration that strongly correlate with arthroscopy results. The correlation between the quantitative OCT values and T2 values for the superficial cartilage further supports the utility of OCT as a clinical research tool, providing quantifiable microscopic resolution data on the articular cartilage structure. New technologies for nondestructive quantitative assessment of human articular cartilage degeneration may facilitate the development of strategies to delay or prevent the onset of OA.
Chu
Constance R
CR
Cartilage Restoration Center, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA. chucr@upmc.edu
Williams
Ashley
A
Tolliver
David
D
Kwoh
C Kent
CK
Bruno
Stephen
S
Irrgang
James J
JJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D001182:Arthroscopy; D002358:Cartilage, Articular / Q000473:pathology*; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008592:Menisci, Tibial / Q000473:pathology*; D008875:Middle Aged; D015588:Observer Variation; D020370:Osteoarthritis, Knee / Q000473:pathology*; D000070600:Tibial Meniscus Injuries; D041623:Tomography, Optical Coherence / Q000379:methods* / Q000706:statistics & numerical data; D055815:Young Adult