Knee articular cartilage injury treatment with matrix-induced autologous chondrocyte implantation (MACI): correlation at 24 and 120 months between clinical and radiological findings using MR arthrography.
OBJECTIVE
To evaluate the long-term evolution of matrix-induced autologous chondrocyte implantation (MACI) with magnetic resonance (MR) arthrography and verify the correlation between radiological and clinical findings.


MATERIALS AND METHODS
Twenty-six patients (20 m/6f) were diagnosed with knee chondral injuries and treated with MACI implantation. Each patient received MR arthrography and clinical examination at mid-term (range 22-36 months) and long term (range 96-194 months) after surgery. MR arthrography was performed with dedicated coil and a 1.5-Tesla MR unit. The modified MOCART scale was used to evaluate the status of chondral implants. Implant coating, integration to the border zone, and the surface and structure of the repaired tissue were evaluated. Presence of bone marrow oedema was evaluated. The Cincinnati Knee Rating System (CKRS) was used for clinical assessment.


RESULTS
At long term, 4/26 patients had complete alignment; 5/26 had a complete integration of the margins; in 4/26 cases, the implant surface was undamaged; in 14/26 cases, the reparative tissue was homogeneous. In 9/26 cases, the implant showed isointense signal compared to articular cartilage, while the presence of subchondral bone oedema was documented in 19/26 cases. The average radiological score decreased from 59.2 (mid-term) to 38.6 (long term). The average clinical score decreased from 8.9 to 8.3.


CONCLUSIONS
Decrease in clinical results was not significant (0.6 points p = .06), but mMOCART scores decreased significantly (p = .00003). Although imaging studies showed deterioration of the grafts, the patients did not have significant clinical deterioration (231/250).
['Calvi|Marco|M|', 'Curti|Marco|M|', 'Ossola|Christian|C|http://orcid.org/0000-0003-0672-1573', 'Duvia|Marta|M|', 'Angeretti|Maria Gloria|MG|', 'Ronga|Mario|M|', 'Genovese|Eugenio Annibale|EA|']
D001175:Arthrography D002358:Cartilage, Articular D019902:Chondrocytes D005500:Follow-Up Studies D006801:Humans D007719:Knee Joint D008279:Magnetic Resonance Imaging D009682:Magnetic Resonance Spectroscopy D014182:Transplantation, Autologous D016896:Treatment Outcome
Articular Cartilage Chondrocytes Arthrography Follow-up studies Magnetic resonance imaging