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MRI showed imaging abnormalities but good clinical results with ACI

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CHICAGO — MRI appearance of autologous chondrocyte implantation showed imaging abnormalities at 65.8-month follow-up; however, autologous chondrocyte implantation was still found to produce good clinical results, according to data presented at the International Cartilage Repair Society Annual Meeting, here.

“MRI appearance of ACI [autologous chondrocyte implantation] grafts at a mean 65.8-month follow-up did show a wide variation in abnormalities despite good or excellent clinical results,” Keith Chan, MD, said in his presentation. “Our study suggests that patients with excellent clinical scores did not have increase in marrow edema or increase in cystic lesions, although more research needs to be carried out to prove that point. Overall, MRI abnormalities following ACI should be interpreted with caution in regard to clinical outcome.”

Chan and colleagues reviewed 24 grafts at a mean 65.8 months following ACI for osteochondral lesions of the talus. The researchers compared graft appearance with preoperative MRI and evaluated for defect fill, surface regularity, signal pattern, bone marrow edema, subchondral plate irregularity and presence of cystic lesions.

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Chan noted 92% of grafts had a defect fill of more than 75%, and all of the grafts had a mildly or moderately irregular articular surface. Results also showed almost all patients had heterogeneous signal pattern.

“A third of [patients] had no cysts, 29% had a decrease in cysts and 8% had no change in cystic lesions,” Chan said.

He added 63% of patients had decreasing bone edema and 17% had no change. Clinical outcome scores had a mean improvement of 39.4, and no significant difference was found between the final American Orthopaedic Foot and Ankle Society score between groups, according to the researchers. – by Casey Tingle

Reference:

Chan K, et al. Correlation of MRI appearance of autologous chondrocyte implantation in the ankle with clinical outcome. Presented at: International Cartilage Repair Society Annual Meeting. May 8-11, 2015; Chicago.

Disclosure: Chan reports he is a paid presenter or speaker for Mitek.