Promising radiological outcome after repair of acetabular chondral defects by microfracture augmented with chitosan-based scaffold: mid-term T2 mapping evaluation

摘要

Purpose Radiological evaluation of the repair tissue produced after arthroscopic treatment of acetabular chondral lesions associated with femoroacetabular impingement (FAI) by the chitosan-based scaffold. Methods Patients of age 18-55 years with clinical and radiological features of FAI and non-arthritic non-dysplastic hips were selected for arthroscopic treatment. Full-thickness acetabular chondral defects were filled with chitosan-based scaffold material after microfracture. T2 mapping was carried out for all patients after 24 months using a 1.5-T machine. Nine regions of interest (ROIs) were localized from three consecutive sagittal slices including the area of repair. T2 relaxation times of ROIs in the repair area were compared with the corresponding posterior cartilage. Results Twenty-one patients, 17 men and 4 women, underwent arthroscopic treatment of full-thickness acetabular chondral defects with mean size of 3.6 +/- 1 cm(2)(range 2-6 cm(2)). Zone 2 was affected in all cases while zone 3 was involved in 13 cases. T2 relaxation values were collected from 189 ROIs for quantitative analysis. Within the peripheral repair area, the mean T2 value was 49.1 +/- 7.2 ms (ms), while ROIs of the central repair area had mean T2 values of 50.2 +/- 7.1 ms. Posterior cartilage showed mean T2 value of 46.2 +/- 7.6 ms Conclusion Arthroscopic microfracture of large full-thickness acetabular chondral defects with chitosan-based scaffold produced a homogenous repair tissue similar to the corresponding native cartilage of the same joint on quantitative T2 mapping at mid-term follow-up. Clinical relevance: augmentation of the microfracture by chitosan-based scaffold is a promising modality for treatment of large full-thickness acetabular defects.