The mission of this workgroup is to pursue the continued research surrounding the pre and post-operative recommendations for cartilage-based surgical interventions. We will strive to incorporate a methodological approach to pre and post operative care in order to elucidate the optimal patient management including patient education, safe and effective treatment measures, functional outcome measurements and return to prior level of function, including return to sport.
Our initiatives include a continuation of our efforts outlined during the Zurich Rehabilitation Meeting in 2007; which focused on the establishment of clinical rehabilitation guidelines and garnering a consensus statement with respect to pre and post operative care. We wish to improve the level of global awareness for the increasing need to examine rehabilitative practice in cartilage research, from a clinical perspective. This will include the evaluation, analysis, and the detailed reporting of rehabilitation in peer review publication. We also wish to foster a relationship with leading industry researchers to encourage well designed research protocols and methodology with respect to rehabilitation. Our goal is to garner a knowledge base that will enhance our clinical understanding and promote high quality, accessible, and progressive rehabilitation methods through evidence based research.
Karen Hambly, UK
K.Hambly@kent.ac.uk
Kai Mithoefer, USA
kmithoefer@partners.org
Holly Silvers, USA
Hollysilverspt@aol.com
Stefano Della Villa, IT
s.dellavilla@isokinetic.com
Dieter Van Assche, BE
dieter.vanassche@uzleuven.be
The mission of this workgroup is to offer ideas on imaging in cartilage repair, to continuously work on advancing imaging modalities to diagnose and to follow-up cartilage repair procedures and especially to provide helpful information for everyone to improve his capabilities in imaging of cartilage repair.
Related to imaging methods, cartilage repair surgery requires an optimal diagnosis and a non-invasive, standardized, and high-quality longitudinal method to assess the structure of the repair tissue in the follow-up. This goal is best fulfilled by magnetic resonance imaging (MRI). The working group was founded when working together on a review article on MRI of cartilage repair.
Siegfried Trattnig, AT
Siegfried.Trattnig@akhwien.at
Goetz Welsch, DE
goetz.welsch@uk-erlangen.de
Hollis Potter, USA
potterh@hss.edu
Carl Winalski, USA
winalsc@ccf.org
Stefan Marlovits, AT
stefan.marlovits@meduniwien.ac.at
Jukka Jurvelin, FIN
jukka.jurvelin@uku.fi
Thomas Link, USA
thomas.link@radiology.ucsf.edu
Praveen Bilagi, UK
pbilagi@aol.com
Daniel Saris, NL
d.saris@umcutrecht.nl
Tallal Mamisch, CH
mamisch@bwh.harvard.edu
Christine Chung, US
cbchung@ucsd.edu
Takashi Nishii, JP
nishii@ort.med.osaka-u.ac.jp
Suggested MR imaging requirements for cartilage repair are published in the ICRS journal “Cartilage” in a review article by the imaging working group: “Magnetic Resonance Imaging of Cartilage Repair: A Review” including:
Part I: Preclinical Models
i) Basic Requirements
ii) Use of Contrast Agents
iii) Functional, Biomechanical MRI of Repair Tissue
Part II: Clinical Studies
i) Morphological MRI Studies
a. Basic MR Technical Requirements
b. Cartilage-Specific Sequences
c. MR Classification Systems Based on Morphology
d. MR Findings of Following Specific Cartilage Repair Techniques
e. MR Follow-up in Correlation to Clinical Outcome
ii) Functional (Biochemical) MRI: Clinical Studies
a. dGEMRIC for Assessment of Cartilage Repair
b. Quantitative MR T1rho
c. T2 Mapping
d. Magnetization Transfer Contrast
e. Diffusion-Weighted Imaging
Part III: Regulatory Issues
i) Food and Drug Administration (FDA)
ii) European Medicines Agency (EMEA)
Based on the above mentioned review article and on the long experience in exploiting MR imaging methodologies in cartilage repair, three imaging biomarkers for cartilage repair were defined in the context of current and future techniques. A recent presentation on this topic at the 5th International Osteoarthritis Workshop in Salzburg, Austria in June 2011 is available as a pdf file.
A good MR imaging protocol is based on many prerequisites. Different factors like the field strength, the bore, the coil or the vendor are playing a role. Furthermore the specific local requirements of the surgeons and the radiologist are playing an important role. Today especially time issues play an important role and not only the knee joint is in the focus of MR imaging in cartilage repair. Hence it will not be possible to provide a standard MR protocol for cartilage repair patients and furthermore it is not applicable to provide specific imaging parameters. Nevertheless to provide some help to implement a high quality MR protocol based on the specific vendor (alphabetically), possible standard protocols are provided together with possible contact persons and reference sites:
General Electrics:
Protocol: (to come)
Reference site and contact persons: (to come)
Philips:
Protocol: (to come)
Reference site and contact persons: (to come)
Siemens:
Protocol: (to come)
Reference site and contact persons: (to come)
Organization of an ICRS Imaging Course, Autumn 2012.