Validation of a novel blinding method for measuring postoperative knee articular cartilage using magnetic resonance imaging

Rebecca Moyer^{1

2}, Trevor Birmingham^{3

4

5}, Felix Eckstein^{6

7}, Wolfgang Wirth^{6

7}, Susanne Maschek^{6

7}, Blaine Chronik⁸, J Robert Giffin^{9

10

11}

Affiliations

¹ Faculty of Health, School of Physiotherapy, Dalhousie University, 5869 University Ave, Forrest Building, PO Box 15000, Halifax, NS, B3H 4R2, Canada. rebecca.moyer@dal.ca.
² Bone and Joint Institute, Western University, London, ON, Canada. rebecca.moyer@dal.ca.
³ Wolf Orthopaedic Biomechanics Laboratory, Fowler Kennedy Sport Medicine Clinic, Western University, London, ON, Canada. tbirming@uwo.ca.
⁴ Bone and Joint Institute, Western University, London, ON, Canada. tbirming@uwo.ca.
⁵ Faculty of Health Sciences, School of Physical Therapy, Western University, London, ON, Canada. tbirming@uwo.ca.
⁶ Institute of Anatomy, Paracelsus Medical University Salzburg and Nuremberg, Salzburg, Austria.
⁷ Chondrometrics GmbH, Ainring, Germany.
⁸ The xMR Labs, Department of Physics and Astronomy, Western University, London, ON, Canada.
⁹ Wolf Orthopaedic Biomechanics Laboratory, Fowler Kennedy Sport Medicine Clinic, Western University, London, ON, Canada.
¹⁰ Bone and Joint Institute, Western University, London, ON, Canada.
¹¹ Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.

PMID: 31300932
DOI: 10.1007/s10334-019-00766-y

Validation of a novel blinding method for measuring postoperative knee articular cartilage using magnetic resonance imaging

Rebecca Moyer et al. MAGMA. 2019 Dec.

. 2019 Dec;32(6):693-702.

doi: 10.1007/s10334-019-00766-y. Epub 2019 Jul 12.

Authors

Rebecca Moyer^{1

2}, Trevor Birmingham^{3

4

5}, Felix Eckstein^{6

7}, Wolfgang Wirth^{6

7}, Susanne Maschek^{6

7}, Blaine Chronik⁸, J Robert Giffin^{9

10

11}

Affiliations

¹ Faculty of Health, School of Physiotherapy, Dalhousie University, 5869 University Ave, Forrest Building, PO Box 15000, Halifax, NS, B3H 4R2, Canada. rebecca.moyer@dal.ca.
² Bone and Joint Institute, Western University, London, ON, Canada. rebecca.moyer@dal.ca.
³ Wolf Orthopaedic Biomechanics Laboratory, Fowler Kennedy Sport Medicine Clinic, Western University, London, ON, Canada. tbirming@uwo.ca.
⁴ Bone and Joint Institute, Western University, London, ON, Canada. tbirming@uwo.ca.
⁵ Faculty of Health Sciences, School of Physical Therapy, Western University, London, ON, Canada. tbirming@uwo.ca.
⁶ Institute of Anatomy, Paracelsus Medical University Salzburg and Nuremberg, Salzburg, Austria.
⁷ Chondrometrics GmbH, Ainring, Germany.
⁸ The xMR Labs, Department of Physics and Astronomy, Western University, London, ON, Canada.
⁹ Wolf Orthopaedic Biomechanics Laboratory, Fowler Kennedy Sport Medicine Clinic, Western University, London, ON, Canada.
¹⁰ Bone and Joint Institute, Western University, London, ON, Canada.
¹¹ Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.

PMID: 31300932
DOI: 10.1007/s10334-019-00766-y

Abstract

Objectives: To test PEEK implant-associated MRI artifacts, a method for blinding MRI readers, the repeatability of cartilage thickness measures before and 6 weeks after high tibial osteotomy (HTO), and the sensitivity to change of cartilage thickness 12 months after HTO.

Materials and methods: Ten patients underwent HTO using a PEEK implant and 3 T-MRI before, 6 weeks and 12 months after surgery. Masks were applied to hide implant visibility on 48 MRI pairs, which were assessed by 7 readers (blinded to time). One blinded reader measured femorotibial cartilage thickness from masked MRIs.

Results: No artifacts were produced. Readers were unable to identify scans by time greater than by chance. Cartilage thickness before and 6 weeks after surgery was not significantly different and indicated excellent repeatability. Medial cartilage thickness increases 12 M postoperatively approached statistical significance (p = 0.06), with no lateral changes observed. Half of the participants had an increase in medial cartilage thickness at 12 M that exceeded the minimal detectable change. Standardized response mean values were moderate-to-large.

Discussion: Postoperative measures of cartilage thickness are repeatable, consistent and sensitive to change when artifact is eliminated, and a validated blinding technique is used. These results provide proof of concept for accurately measuring increases in medial knee articular cartilage after medial opening wedge HTO.

Keywords: Articular cartilage; Knee; Magnetic resonance imaging; Osteoarthritis; Osteotomy.

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References

1. Osteoarthritis Cartilage. 2006 Oct;14(10):974-83 - PubMed
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1. Osteoarthritis Cartilage. 2011 May;19(5):589-605 - PubMed
1. Arthritis Care Res (Hoboken). 2017 Jul;69(7):959-965 - PubMed
1. Arthritis Rheumatol. 2014 Jul;66(7):1820-31 - PubMed

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Validation of a novel blinding method for measuring postoperative knee articular cartilage using magnetic resonance imaging

Affiliations

Validation of a novel blinding method for measuring postoperative knee articular cartilage using magnetic resonance imaging

Authors

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Abstract

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Medical