PMID- 36064155
OWN - NLM
STAT- MEDLINE
DCOM- 20230109
LR  - 20230207
IS  - 1526-3231 (Electronic)
IS  - 0749-8063 (Linking)
VI  - 39
IP  - 2
DP  - 2023 Feb
TI  - Mosaicplasty With High Tibial Osteotomy for Knee Subchondral Insufficiency 
      Fracture Had Better Magnetic Resonance Observation of Cartilage Repair Tissue 
      Scores With Less Bone Marrow Edema and Better Plug Union and Less Plug Necrosis 
      Compared With Mosaicplasty Alone.
PG  - 337-346
LID - S0749-8063(22)00479-0 [pii]
LID - 10.1016/j.arthro.2022.07.020 [doi]
AB  - PURPOSE: To determine the magnetic resonance imaging (MRI) findings after 
      mosaicplasty (MOS) for knee subchondral insufficiency fracture (SIFK), and to 
      analyze the relationship between MRI findings and clinical outcomes. METHODS: We 
      retrospectively reviewed the cases of consecutive patients who underwent MOS for 
      SIFK with/without high tibial osteotomy (HTO) between January 1998 and December 
      2015. The MRI findings at 12 months after the surgery were assessed by the 
      modified magnetic resonance observation of cartilage repair tissue (MOCART) score 
      to determine the degree of bone marrow edema (BME), plug union, and plug 
      necrosis. The clinical outcomes were assessed by Lysholm score to clarify the 
      minimal clinically important difference (MCID) and patient acceptable symptom 
      state analysis. RESULTS: In total, 58 patients (17 men and 41 women) were 
      enrolled in this study. Among them, 30 knees were treated by MOS alone and 28 
      knees were treated by MOS with HTO. The MOCART scores of patients who received 
      MOS alone were significantly lower in BME score (P = .0060), plug union score 
      (P = .0216), and in plug necrosis score (P = .0326) than patients who received 
      MOS with HTO. BME lesion was less likely to persist among elderly (odds ratio 
      1.20, P = .0248) and female (OR 41.8, P = .0118) patients. The MCID of Lysholm 
      score was 6.6 in MOS alone and 8.4 in MOS with HTO cases, but there were no 
      significant association between MRI findings and the postoperative Lysholm score. 
      CONCLUSIONS: The MOS with HTO cases had better MOCART scores with less BME, 
      better plug union, and less plug necrosis compared with MOS alone cases. Female 
      and older patients had better resolution of BME, but there was no significant 
      correlation between MRI findings and the postoperative Lysholm score. All cases 
      in both groups showed improvement of Lysholm score exceeding MCID; thus, MOS may 
      be effective as a joint preserving surgery for SIFK. LEVEL OF EVIDENCE: Level IV, 
      clinical case series.
CI  - Copyright (c) 2022 Arthroscopy Association of North America. Published by Elsevier 
      Inc. All rights reserved.
FAU - Mukai, Shogo
AU  - Mukai S
AD  - Department of Orthopedic Surgery, National Hospital Organization Kyoto Medical 
      Center, Kyoto, Japan. Electronic address: shomu67d@gmail.com.
FAU - Nakagawa, Yasuaki
AU  - Nakagawa Y
AD  - Department of Orthopedic Surgery, National Hospital Organization Kyoto Medical 
      Center, Kyoto, Japan.
FAU - Nishitani, Kohei
AU  - Nishitani K
AD  - Department of Orthopedic Surgery, National Hospital Organization Kyoto Medical 
      Center, Kyoto, Japan; Department of Orthopedic Surgery, Kyoto University, Kyoto, 
      Japan.
FAU - Sakai, Sayako
AU  - Sakai S
AD  - Department of Orthopedic Surgery, National Hospital Organization Kyoto Medical 
      Center, Kyoto, Japan.
FAU - Nakamura, Ryouta
AU  - Nakamura R
AD  - Department of Orthopedic Surgery, National Hospital Organization Kyoto Medical 
      Center, Kyoto, Japan.
FAU - Takahashi, Motoi
AU  - Takahashi M
AD  - Department of Orthopedic Surgery, National Hospital Organization Kyoto Medical 
      Center, Kyoto, Japan.
LA  - eng
PT  - Journal Article
DEP - 20220903
PL  - United States
TA  - Arthroscopy
JT  - Arthroscopy : the journal of arthroscopic & related surgery : official 
      publication of the Arthroscopy Association of North America and the International 
      Arthroscopy Association
JID - 8506498
SB  - IM
CIN - Arthroscopy. 2023 Feb;39(2):347-348. PMID: 36604001
MH  - Male
MH  - Humans
MH  - Female
MH  - Aged
MH  - Retrospective Studies
MH  - Bone Marrow
MH  - *Fractures, Stress
MH  - Treatment Outcome
MH  - Knee Joint/surgery
MH  - Magnetic Resonance Imaging
MH  - *Knee Fractures
MH  - Magnetic Resonance Spectroscopy
MH  - Cartilage
MH  - Necrosis/surgery
MH  - Osteotomy/methods
MH  - Edema/etiology
MH  - *Osteoarthritis, Knee/surgery
EDAT- 2022/09/06 06:00
MHDA- 2023/01/10 06:00
CRDT- 2022/09/05 19:28
PHST- 2022/01/06 00:00 [received]
PHST- 2022/07/20 00:00 [revised]
PHST- 2022/07/28 00:00 [accepted]
PHST- 2022/09/06 06:00 [pubmed]
PHST- 2023/01/10 06:00 [medline]
PHST- 2022/09/05 19:28 [entrez]
AID - S0749-8063(22)00479-0 [pii]
AID - 10.1016/j.arthro.2022.07.020 [doi]
PST - ppublish
SO  - Arthroscopy. 2023 Feb;39(2):337-346. doi: 10.1016/j.arthro.2022.07.020. Epub 2022 
      Sep 3.