In-Situ Cartilage Functionality Assessment Based on Advanced MRI Techniques and Precise Compartmental Knee Joint Loading through Varus and Valgus Stress
Diagnostics, vol. 11, pp. 1476
Abstract
Stress MRI brings together mechanical loading and MRI in the functional assessment of cartilage and meniscus, yet lacks basic scientific validation. This study assessed the response-to-loading patterns of cartilage and meniscus incurred by standardized compartmental varus and valgus loading of the human knee joint. Eight human cadaveric knee joints underwent imaging by morphologic (i.e., proton density-weighted fat-saturated and 3D water-selective) and quantitative (i.e., T1ρ and T2 mapping) sequences, both unloaded and loaded to 73.5 N, 147.1 N, and 220.6 N of compartmental pressurization. After manual segmentation of cartilage and meniscus, morphometric measures and T2 and T1ρ relaxation times were quantified. CT-based analysis of joint alignment and histologic and biomechanical tissue measures served as references. Under loading, we observed significant decreases in cartilage thickness (p < 0.001 (repeated measures ANOVA)) and T1ρ relaxation times (p = 0.001; medial meniscus, lateral tibia; (Friedman test)), significant increases in T2 relaxation times (p ≤ 0.004; medial femur, lateral tibia; (Friedman test)), and adaptive joint motion. In conclusion, varus and valgus stress MRI induces meaningful changes in cartilage and meniscus secondary to compartmental loading that may be assessed by cartilage morphometric measures as well as T2 and T1ρ mapping as imaging surrogates of tissue functionality.
Authors 10
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Affiliation as printed
Department of Diagnostic and Interventional Radiology, Aachen University Hospital, 52074 Aachen, Germany
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Justus Schock corresponding
Heinrich Heine University Düsseldorf
Affiliation as printed
Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, 40225 Dusseldorf, Germany
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Heinrich Heine University Düsseldorf
Affiliation as printed
Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, 40225 Dusseldorf, Germany
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Affiliation as printed
Department of Diagnostic and Interventional Radiology, Aachen University Hospital, 52074 Aachen, Germany
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Affiliation as printed
Department of Diagnostic and Interventional Radiology, Aachen University Hospital, 52074 Aachen, Germany
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Affiliation as printed
Department of Diagnostic and Interventional Radiology, Aachen University Hospital, 52074 Aachen, Germany
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Affiliation as printed
Department of Orthopedic and Trauma Surgery, Lucerne Cantonal Hospital, 6000, Lucerne, Switzerland
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Affiliation as printed
Institute of Molecular and Cellular Anatomy, RWTH Aachen University, 52074 Aachen, Germany
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Affiliation as printed
Department of Diagnostic and Interventional Radiology, Aachen University Hospital, 52074 Aachen, Germany
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Affiliation as printed
Department of Diagnostic and Interventional Radiology, Aachen University Hospital, 52074 Aachen, Germany
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