An MRI-compatible varus–valgus loading device for whole-knee joint functionality assessment based on compartmental compression: a proof-of-concept study
Magnetic Resonance Materials in Physics Biology and Medicine, vol. 33, pp. 839–854
Abstract
OBJECTIVE: Beyond static assessment, functional techniques are increasingly applied in magnetic resonance imaging (MRI) studies. Stress MRI techniques bring together MRI and mechanical loading to study knee joint and tissue functionality, yet prototypical axial compressive loading devices are bulky and complex to operate. This study aimed to design and validate an MRI-compatible pressure-controlled varus-valgus loading device that applies loading along the joint line. METHODS: Following the device's thorough validation, we demonstrated proof of concept by subjecting a structurally intact human cadaveric knee joint to serial imaging in unloaded and loaded configurations, i.e. to varus and valgus loading at 7.5 kPa (= 73.5 N), 15 kPa (= 147.1 N), and 22.5 kPa (= 220.6 N). Following clinical standard (PDw fs) and high-resolution 3D water-selective cartilage (WATSc) sequences, we performed manual segmentations and computations of morphometric cartilage measures. We used CT and radiography (to quantify joint space widths) and histology and biomechanics (to assess tissue quality) as references. RESULTS: We found (sub)regional decreases in cartilage volume, thickness, and mean joint space widths reflective of areal pressurization of the medial and lateral femorotibial compartments. DISCUSSION: Once substantiated by larger sample sizes, varus-valgus loading may provide a powerful alternative stress MRI technique.
Authors 10
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Affiliation as printed
Department of Diagnostic and Interventional Radiology, Aachen University Hospital, Aachen, Germany
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Düsseldorf University Hospital · Heinrich Heine University Düsseldorf · RWTH Aachen University
Affiliation as printed
Department of Diagnostic and Interventional Radiology, Medical Faculty, University Hospital Düsseldorf, University Dusseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
Institute of Computer Vision and Imaging, RWTH University Aachen, Aachen, Germany
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Affiliation as printed
Department of Diagnostic and Interventional Radiology, Aachen University Hospital, Aachen, Germany
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Affiliation as printed
Department of Diagnostic and Interventional Radiology, Aachen University Hospital, Aachen, Germany
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Affiliation as printed
Department of Diagnostic and Interventional Radiology, Aachen University Hospital, Aachen, Germany
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Affiliation as printed
Department of Diagnostic and Interventional Radiology, Aachen University Hospital, Aachen, Germany
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Affiliation as printed
Department of Diagnostic and Interventional Radiology, Aachen University Hospital, Aachen, Germany
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Düsseldorf University Hospital · Heinrich Heine University Düsseldorf
Affiliation as printed
Department of Diagnostic and Interventional Radiology, Medical Faculty, University Hospital Düsseldorf, University Dusseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
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Daniel Truhn Aachen Department of Diagnostic and Interventional Radiology Institute of Computer Vision and Imaging
Universitätsklinikum Aachen · RWTH Aachen University
Affiliation as printed
Department of Diagnostic and Interventional Radiology, Aachen University Hospital, Aachen, Germany
Institute of Computer Vision and Imaging, RWTH University Aachen, Aachen, Germany
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Sven Nebelung corresponding
Düsseldorf University Hospital · Heinrich Heine University Düsseldorf
Affiliation as printed
Department of Diagnostic and Interventional Radiology, Medical Faculty, University Hospital Düsseldorf, University Dusseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany. sven.nebelung@med.uni-duesseldorf.de
Department of Diagnostic and Interventional Radiology, Medical Faculty, University Hospital Düsseldorf, University Dusseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
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