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Compositional MRI reveals biochemical and microstructural changes in cartilage well before changes are visible to the eye/arthroscopist. Compositional MRI focuses on early and potentially reversible injury stages, and may (1) help identify athletes at risk prior to the development of overt joint damage or (2) help to determine time to return to play in a postinjury scenario.1
Compositional MRI is not yet in clinical use, but it is being used with increasing frequency in osteoarthritis (OA) research for ‘pre-morphologic’ evaluation of cartilage (figure 1)2 and to assess biochemical response of joint tissue, primarily cartilage, to loading through physical activity.3 It has been used to image the biochemical response in knees after ACL reconstruction,4 meniscus surgery5 and cartilage repair6 (figure 2).
Defining disease state of osteoarthritis. Adapted from Kwoh.11
Knee of a patient 24 months after microfracture cartilage repair of the medial central femoral condyle. (A) Sagittal three-dimentional T1-weighted gradient echo MRI showing a normal morphological appearance of the cartilage repair tissue and native medial posterior femoral condyle …
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