Optical coherence tomography detection of subclinical traumatic cartilage injury.
Optical coherence tomography detection of subclinical traumatic cartilage injury.
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DOI：
10.1097/bot.0b013e3181f17a3b
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发表时间：
2010-09
影响因子：
2.3
通讯作者：
Chu CR
中科院分区：
文献类型：
--
作者：
Bear DM;Szczodry M;Kramer S;Coyle CH;Smolinski P;Chu CR
Post-traumatic arthritis is a major cause of disability. Current clinical imaging modalities are unable to reliably evaluate articular cartilage damage prior to surface breakdown, when potentially reversible changes are occurring. Optical Coherence Tomography (OCT) is a nondestructive imaging technology that can detect degenerative changes in articular cartilage with an intact surface. This study tests the hypothesis that OCT detects acute articular cartilage injury following impact at energy levels resulting in chondrocyte death and microstructural changes, but insufficient to produce macroscopic surface damage. Bovine osteochondral cores underwent OCT imaging and were divided into a control with no impact or were subjected to low (0.175 J) or moderate (0.35 J) energy impact. Cores were reimaged with OCT following impact and the OCT signal intensity quantified. A ratio of the superficial to deep layer intensities was calculated and compared before and after impact. Chondrocyte viability was determined one day after impact, followed by histology and polarized microscopy. Macroscopic changes to the articular surface were not observed following low and moderate impact. The OCT signal intensity ratio demonstrated a 27% increase (p=0.006) following low impact, and a 38% increase (p=0.001) following moderate impact. Cell death increased by 150% (p<0.001) and 200% (p<0.001) after low and moderate energy impacts, respectively. When compared to unimpacted controls, both Mankin histology and David-Vaudey polarized microscopy scores increased (p=0.036, p=0.002, respectively) following moderate energy impact. This study shows that OCT detects acute cartilage changes after impact injury at levels insufficient to cause visible damage to the articular surface, but sufficient to cause chondrocyte death and microscopic matrix damage. This finding supports the utility of OCT to detect microstructural subsurface cartilage damage that is poorly visualized with conventional imaging.
