Dataset Information

MRI after patellofemoral replacement: the component-bone interface and rotational alignment.

ABSTRACT:

Background

In an earlier paper, it was shown that tailored magnetic resonance imaging (MRI) allows for reproducible analysis of the preserved knee joint structures after patellofemoral replacement (PFR).

Purposes

This pilot study investigates to what degree MRI could produce reliable assessment of the implant-bone interface of femoral and patellar components and rotational alignment following PFR.

Methods

MRI tailored for reduction of metallic artefacts was performed in seven patients who had undergone PFR. Two independent investigators evaluated the implant-bone interface at femoral and patellar components and the rotational alignment of the femoral component. They also assessed their degree of confidence in evaluation using a five-point scale. The inter-observer reliability was determined.

Results

Implant-induced MRI artefact was barely observed and there was no interference with component-bone interface evaluation. There was excellent inter-observer reliability, inter-observer agreement, and confidence for the implant-bone interface at femoral and patellar components and for rotational alignment. The applied score for the interface was found to be reliable.

Conclusion

Tailored MRI allows reproducible analysis of the implant-bone interface and of rotational alignment of the femoral component in patients who have had PFR. It might prove helpful in the assessment of painful PFR.

SUBMITTER: Heyse TJ

PROVIDER: S-EPMC3757485 | biostudies-literature | 2013 Jul

REPOSITORIES: biostudies-literature

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Publications

MRI after patellofemoral replacement: the component-bone interface and rotational alignment.

Heyse Thomas J TJ Figiel Jens J Hähnlein Ulrike U Timmesfeld Nina N Schofer Markus D MD Fuchs-Winkelmann Susanne S Efe Turgay T

HSS journal : the musculoskeletal journal of Hospital for Special Surgery 20130626 2

<h4>Background</h4>In an earlier paper, it was shown that tailored magnetic resonance imaging (MRI) allows for reproducible analysis of the preserved knee joint structures after patellofemoral replacement (PFR).<h4>Purposes</h4>This pilot study investigates to what degree MRI could produce reliable assessment of the implant-bone interface of femoral and patellar components and rotational alignment following PFR.<h4>Methods</h4>MRI tailored for reduction of metallic artefacts was performed in sev ...[more]

PMID: 24426854

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Project description:BackgroundThe most common modes of failure of cemented unicompartmental knee arthroplasty (UKA) designs are aseptic loosening and unexplained pain at short- to mid-term follow-up, which is likely linked to early fixation failure. Determining these modes of failure remains challenging; conventional radiographs are limited for use in assessing radiolucent lines, with only fair sensitivity and specificity for aseptic loosening.Questions/purposesWe sought to characterize the bone-component interface of patients with symptomatic cemented medial unicompartmental knee arthroplasty (UKA) using magnetic resonance imaging (MRI) and to determine the relationship between MRI and conventional radiographic findings.MethodsThis retrospective observational study included 55 consecutive patients with symptomatic cemented UKA. All underwent MRI with addition of multiacquisition variable-resonance image combination (MAVRIC) at an average of 17.8 ± 13.9 months after surgery. MRI studies were reviewed by two independent musculoskeletal radiologists. MRI findings at the bone-cement interface were quantified, including bone marrow edema, fibrous membrane, osteolysis, and loosening. Radiographs were reviewed for existence of radiolucent lines. Inter-rater agreement was determined using Cohen's κ statistic.ResultsThe vast majority of symptomatic UKA patients demonstrated bone marrow edema pattern (71% and 75%, respectively) and fibrous membrane (69% and 89%, respectively) at the femoral and tibial interface. Excellent and substantial inter-rater agreement was found for the femoral and tibial interface, respectively. Furthermore, MRI findings and radiolucent lines observed on conventional radiographs were poorly correlated.ConclusionMRI with the addition of MAVRIC sequences could be a complementary tool for assessing symptomatic UKA and for quantifying appearances at the bone-component interface. This technique showed good reproducibility of analysis of the bone-component interface after cemented UKA. Future studies are necessary to define the bone-component interface of symptomatic and asymptomatic UKA patients.

Project description:ObjectiveLoading is invariably an important factor of consideration for understanding the causality flow and parallel existence of articular cartilage and subchondral bone changes. The goal of this study was to investigate the patterns of subregional 18NaF-SUV vs. T1p-T2 associations and vertical ground reaction force loading rates; in isolated patellofemoral-joint-osteoarthritis (PFJ-OA) patients.MethodThirty-five isolated PFJ-OA patients, with no tibiofemoral involvement, underwent simultaneous scans in a 3.0T whole-body hybrid positron emission tomography-magnetic resonance imaging scanner. MRI Whole-Organ Magnetic Resonance Imaging Scoring assessments were performed to identify/confirm isolated PFJ-OA knees from bilateral scans. T1p-T2 relaxation and SUV values were automatically computed for both trochlear and patellar cartilage and subchondral bone subregions (deep, superficial, lateral, and medial). Maximum vertical impact loading rates (Loading-RateNorm) were calculated from walking trials. Relationships were explored between SUV uptake, T1p-T2 values, and Loading-RateNorm via linear mixed-effects modeling.ResultsSignificant and complex association patterns were noted between medial and lateral bone 18NaF-SUV uptakes vs. medial and lateral cartilage sub-regional T1p and T2. SUVMean and SUVMax were positively associated with deep cartilage subregional T1pand T2 values; and negatively associated with superficial cartilage subregional T1p-T2 values in both medial and lateral regions. Both medial and lateral bone 18NaF-SUVMean and SUVMax uptakes remained positively associated with the individual gait characteristics, i.e., peak vertical impact loading rates (Loading-RateNorm).ConclusionEvidence of simultaneous, complementary, cross-sectional associations between T1p-T2 values and peak vertical loading rates with 18NaF-SUV, have been rare in the isolated PFJ-OA cohort. The clinical implications of such novel associations remain of utmost importance from a gait retraining perspective.

Dataset Information

MRI after patellofemoral replacement: the component-bone interface and rotational alignment.

Background

Purposes

Methods

Results

Conclusion

Publications

MRI after patellofemoral replacement: the component-bone interface and rotational alignment.

Similar Datasets

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