title: [MRI based volumetric assessment of knee cartilage after ACL-reconstruction, correlated with qualitative morphologic changes in the joint and with clinical outcome. Is there evidence for early posttraumatic degeneration?].
abstract: OBJECTIVE
  The purpose of this study was to analyze potential quantitative and qualitative changes of the knee cartilage and joint indicative of early posttraumatic OA 4 years after ACL-reconstruction and to correlate the MRI-findings with the clinical outcome (CO).
  
  
  METHODS
  1.5 T MRI-scans were performed on 9 patients post-op and 4 years later. Using a high-resolution T 1-w-fs-FLASH-3D-sequence cartilage volume (cVol) and thickness (mTh) were quantified. Using standard PD-w fs and T 1-w sequences qualitative changes of the joint structures were analyzed based on the WORMS-score. CO was rated by an orthopaedic surgeon using Lysholm-score, OAK-score, Tegner-activity-score (TAS), and Arthrometer KT-1000 testing.
  
  
  RESULTS
  Mean changes of cVol were -1.8 % (range: -5.9 %; + 0.7 %) and of mTh -0.8 % (range: -3.0 %; + 1.1 %). No significant change (95 %-CI) could be identified for any compartment. Three patients developed new peripatellar ostheophytes, acute trauma related changes mostly decreased. Mean outcome of Lysholm-score and OAK-score were 90 pts and 86 pts, mean TAS was 4.3 pts. Average maximum tibial translation reached 5.2 mm comparing to 6.7 mm on the healthy contralateral side.
  
  
  CONCLUSIONS
  Despite a tendency towards decreased cVol and mTh 4 years after ACL-reconstruction qMRI revealed no significant cartilage loss. Newly developing osteophytes did not match with the observed good CO. This small pilot study motivates future quantitative and qualitative-structural MRI-based assessment of articular cartilage and other joint structures in order to improve diagnostic tools for the detection of early OA.
authors.affiliation: Department of Clinical Radiology, Ludwig-Maximilians Universität München. andreas.arnoldi@med.uni-muenchen.de
authors.forename: A P
authors.initials: AP
authors.lastname: Arnoldi
authors.forename: S
authors.initials: S
authors.lastname: Weckbach
authors.forename: C
authors.initials: C
authors.lastname: Nussbickel
authors.forename: A
authors.initials: A
authors.lastname: Horng
authors.forename: I
authors.initials: I
authors.lastname: Nöbauer
authors.forename: S
authors.initials: S
authors.lastname: Zysk
authors.forename: M
authors.initials: M
authors.lastname: Reiser
authors.forename: C
authors.initials: C
authors.lastname: Glaser
mesh_terms: D000328:Adult; D059549:Anterior Cruciate Ligament Reconstruction; D002358:Cartilage, Articular / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007719:Knee Joint / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000175:diagnosis* / Q000473:pathology; D010865:Pilot Projects; D011183:Postoperative Complications / Q000175:diagnosis* / Q000473:pathology; D012680:Sensitivity and Specificity; D012984:Software