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. 2022 Apr 29;7(2):24730114221092021.
doi: 10.1177/24730114221092021. eCollection 2022 Apr.

Correlation of Postoperative Imaging With MRI and Clinical Outcome After Cartilage Repair of the Ankle: A Systematic Review and Meta-analysis

Manuel Waltenspül  1   2 , Christoph Zindel  1 , Franziska C S Altorfer  1 , Stephan Wirth  1 , Jakob Ackermann  1   3
Affiliations

Correlation of Postoperative Imaging With MRI and Clinical Outcome After Cartilage Repair of the Ankle: A Systematic Review and Meta-analysis

Manuel Waltenspül et al. Foot Ankle Orthop. .

Abstract

Background: Magnetic resonance imaging (MRI) is commonly used for evaluation of ankle cartilage repair, yet its association with clinical outcome is controversial. This study analyzes the correlation between MRI and clinical outcome after cartilage repair of the talus including bone marrow stimulation, cell-based techniques, as well as restoration with allo- or autografting.

Methods: A systematic search was performed in MEDLINE, Embase, and Cochrane Collaboration. Articles were screened for correlation of MRI and clinical outcome. Guidelines of Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) were used. Chi-square test and regression analysis were performed to identify variables that determine correlation between clinical and radiologic outcome.

Results: Of 2687 articles, a total of 43 studies (total 1212 cases) were included with a mean Coleman score of 57 (range, 33-70). Overall, 93% were case series, and 5% were retrospective and 2% prospective cohort studies. Associations between clinical outcome and ≥1 imaging variable were found in 21 studies (49%). Of 24 studies (56%) using the composite magnetic resonance observation of cartilage repair tissue (MOCART) score, 7 (29%) reported a correlation of the composite score with clinical outcome. Defect fill was associated with clinical outcome in 5 studies (12%), and 5 studies (50%) reported a correlation of T2 mapping and clinical outcome. Advanced age, shorter follow-up, and larger study size were associated with established correlation between clinical and radiographic outcome (P = .021, P = .028, and P = .033).

Conclusion: Interpreting MRI in prediction of clinical outcome in ankle cartilage repair remains challenging; however, it seems to hold some value in reflecting clinical outcome in patients with advanced age and/or at a shorter follow-up. Yet, further research is warranted to optimize postoperative MRI protocols and assessments allowing for a more comprehensive repair tissue evaluation, which eventually reflect clinical outcome in patients after cartilage repair of the ankle.Level of Evidence: Level III, systematic review and meta-analysis.

Keywords: T2 mapping; articular cartilage restoration; autologous chondrocyte implantation; bone marrow stimulation; cartilage repair; cell-based repair; clinical outcome; correlation; magnetic resonance imaging; magnetic resonance observation of cartilage repair tissue (MOCART); microfracture; morphological; osteochondral autograft transfer system.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. ICMJE forms for all authors are available online.

Figures

Figure 1.
Figure 1.
Flowchart of the literature search.
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References

    1. Ackermann J, Merkely G, Mestriner AB, Shah N, Gomoll AH. Increased chondrocytic gene expression is associated with improved repair tissue quality and graft survival in patients after autologous chondrocyte implantation. Am J Sports Med. 2019;47(12):2919-2926. doi:10.1177/0363546519868213 - DOI - PubMed
    1. Ackermann J, Mestriner AB, Shah N, Gomoll AH. Effect of autogenous bone marrow aspirate treatment on magnetic resonance imaging integration of osteochondral allografts in the knee: a matched comparative imaging analysis. Arthroscopy. 2019;35(8):2436-2444. doi:10.1016/j.arthro.2019.03.033 - DOI - PubMed
    1. Ahn J, Choi JG, Jeong BO. Clinical outcomes after arthroscopic microfracture for osteochondral lesions of the talus are better in patients with decreased postoperative subchondral bone marrow edema. Knee Surg Sports Traumatol Arthrosc. 2021;29(5):1570-1576. doi:10.1007/s00167-020-06303-y - DOI - PubMed
    1. Albano D, Martinelli N, Bianchi A, Messina C, Malerba F, Sconfienza LM. Clinical and imaging outcome of osteochondral lesions of the talus treated using autologous matrix-induced chondrogenesis technique with a biomimetic scaffold. BMC Musculoskelet Disord 2017;18(1):306. doi:10.1186/s12891-017-1679-x - DOI - PMC - PubMed
    1. Anders S, Goetz J, Schubert T, Grifka J, Schaumburger J. Treatment of deep articular talus lesions by matrix associated autologous chondrocyte implantation–results at five years. Int Orthop 2012;36(11):2279-2285. doi:10.1007/s00264-012-1635-1 - DOI - PMC - PubMed

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