title: Matrix-induced autologous chondrocyte implantation of the knee: mid-term and long-term follow-up by MR arthrography.
abstract: OBJECTIVE
  To define magnetic resonance (MR) arthrography imaging findings of matrix-induced autologous chondrocyte implantation (MACI) grafts of the knee in order to describe implant behaviour and to compare findings with validated clinical scores 30 and 60 months after MACI implant.
  
  
  METHODS
  Thirteen patients were recruited (10 male, 3 female) with a total number of 15 chondral lesions. Each patient underwent an MACI procedure and MR arthrography 30 and 60 months after surgery. MR arthrography was performed using a dedicated coil with a 1.5-Tesla unit. The status of the chondral implant was evaluated with the modified MOCART scoring scale. The lining of the implant, the integration to the border zone, the surface and structure of the repaired tissue were assessed, and the presence of bone marrow oedema and effusion was evaluated. For clinical assessment, the Cincinnati score was used.
  
  
  RESULTS
  At 60 months, the abnormality showed worsening in 1 out of 15 cases. Integration showed improvement in 3 out of 15 cases, and worsening in 3 out of 15 cases. Two surfaces of the implant showed further deterioration at 60 months, and 1 afflicted implant fully recovered after the same time interval. Implant contrast enhancement at 30 months was seen in 2 out of 15 cases, 1 of which recovered at 60 months. According to the MOCART score, 4 cases were rated 68.4 out of 75 at 30 months and 65 out of 75 at 60 months. The mean clinical score decreased from 8.6 out of 10 at 30 months to 8.1 out of 10 at 60 months.
  
  
  CONCLUSIONS
  Magnetic resonance arthrography improved the evaluation of implants and facilitated the characterisation of MACI integration with contiguous tissues. The follow-up showed significant changes in MACI, even at 60 months, allowing for useful long-term MR evaluations.
authors.affiliation: Department of Radiology, Insubria University, Via Guicciardini, 21100, Varese, Italy. eugegeno@libero.it
authors.forename: Eugenio
authors.initials: E
authors.lastname: Genovese
authors.forename: Mario
authors.initials: M
authors.lastname: Ronga
authors.forename: Maria Gloria
authors.initials: MG
authors.lastname: Angeretti
authors.forename: Raffaele
authors.initials: R
authors.lastname: Novario
authors.forename: Anna
authors.initials: A
authors.lastname: Leonardi
authors.forename: Mauro
authors.initials: M
authors.lastname: Albrizio
authors.forename: Leonardo
authors.initials: L
authors.lastname: Callegari
authors.forename: Carlo
authors.initials: C
authors.lastname: Fugazzola
mesh_terms: D000328:Adult; D001175:Arthrography; D019902:Chondrocytes / Q000637:transplantation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007718:Knee Injuries / Q000175:diagnosis / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged
references.citation: AJR Am J Roentgenol. 1996 Jul;167(1):127-32
references.pmid: 8659356
references.citation: AJR Am J Roentgenol. 1994 Sep;163(3):629-36
references.pmid: 8079858
references.citation: Magn Reson Imaging. 2005 Sep;23(7):779-87
references.pmid: 16214608
references.citation: J Bone Joint Surg Br. 2003 Sep;85(7):1060-6
references.pmid: 14516048
references.citation: Radiology. 2005 Feb;234(2):501-8
references.pmid: 15616118
references.citation: Osteoarthritis Cartilage. 2009 Jan;17(1):19-25
references.pmid: 18614381
references.citation: Knee Surg Sports Traumatol Arthrosc. 2005 Sep;13(6):451-7
references.pmid: 16170579
references.citation: Invest Radiol. 2000 Oct;35(10):595-601
references.pmid: 11041154
references.citation: Arthroscopy. 2003 Dec;19 Suppl 1:147-53
references.pmid: 14673435
references.citation: Semin Ultrasound CT MR. 2001 Aug;22(4):341-51
references.pmid: 11513158
references.citation: Arthroscopy. 2002 Oct;18(8):925-9
references.pmid: 12368792
references.citation: Radiology. 2003 Jun;227(3):701-7
references.pmid: 12773676
references.citation: Semin Musculoskelet Radiol. 1998;2(4):385-396
references.pmid: 11387117
references.citation: Knee. 2005 Jun;12(3):209-16
references.pmid: 15911295
references.citation: Eur J Radiol. 2006 Jan;57(1):16-23
references.pmid: 16203119
references.citation: Am J Sports Med. 2003 Jan-Feb;31(1):83-6
references.pmid: 12531763
references.citation: N Engl J Med. 1994 Oct 6;331(14):889-95
references.pmid: 8078550
references.citation: Skeletal Radiol. 2003 Apr;32(4):185-200
references.pmid: 12652334
references.citation: J Orthop Sports Phys Ther. 1998 Oct;28(4):192-202
references.pmid: 9785255
references.citation: Arthroscopy. 1997 Aug;13(4):456-60
references.pmid: 9276052
references.citation: J Orthop Sci. 2007 May;12(3):265-73
references.pmid: 17530379
references.citation: Eur J Radiol. 2004 Dec;52(3):310-9
references.pmid: 15544911
references.citation: Ann Anat. 1999 Dec;181(6):513-8
references.pmid: 10609047
references.citation: Radiology. 1991 Feb;178(2):557-61
references.pmid: 1987624
references.citation: Eur Radiol. 2006 May;16(5):1022-30
references.pmid: 16435137
references.citation: J Orthop Surg (Hong Kong). 2003 Jun;11(1):10-5
references.pmid: 12810965
references.citation: Eur J Radiol. 2006 Jan;57(1):9-15
references.pmid: 16183239
references.citation: Clin Orthop Relat Res. 2002 Feb;(395):186-92
references.pmid: 11937880
references.citation: Clin Sports Med. 1999 Jan;18(1):13-44, v-vi
references.pmid: 10028115
references.citation: Eur Radiol. 2007 Jan;17(1):103-18
references.pmid: 16802126
references.citation: Semin Musculoskelet Radiol. 2001 Dec;5(4):345-63
references.pmid: 11745050
references.citation: Eur Cell Mater. 2007 May 15;13:76-86
references.pmid: 17506024
references.citation: Radiol Clin North Am. 2005 Jul;43(4):733-46, viii-ix
references.pmid: 15893534
references.citation: Skeletal Radiol. 2006 Jan;35(1):16-26
references.pmid: 16284767
references.citation: Radiol Clin North Am. 2002 Sep;40(5):1121-32
references.pmid: 12462472
references.citation: Radiology. 1996 Jan;198(1):209-12
references.pmid: 8539380
references.citation: AJR Am J Roentgenol. 1997 Oct;169(4):1089-96
references.pmid: 9308470
references.citation: J Radiol. 2003 Jun;84(6):639-57
references.pmid: 12910170
references.citation: Arthroscopy. 2003 Dec;19 Suppl 1:129-37
references.pmid: 14673432
references.citation: Semin Musculoskelet Radiol. 2006 Dec;10(4):249-57
references.pmid: 17387639
references.citation: Clin Sports Med. 2001 Jul;20(3):565-90
references.pmid: 11494842
references.citation: Clin Orthop Relat Res. 2001 Oct;(391 Suppl):S379-96
references.pmid: 11603721
references.citation: J Bone Joint Surg Am. 1998 Sep;80(9):1276-84
references.pmid: 9759811
references.citation: Radiographics. 2007 Jan-Feb;27(1):207-20; discussion 221-2
references.pmid: 17235008
references.citation: Osteoarthritis Cartilage. 2006 Jan;14(1):47-51
references.pmid: 16242355
references.citation: Am J Sports Med. 2001 Mar-Apr;29(2):213-8
references.pmid: 11292048