Diagnosis of Knee Osteochondral Lesions With Ultrasound

Abstract

Evaluation of articular cartilage and subchondral bone is essential in the diagnosis of joint diseases and injuries. Interobserver and intraobserver reproducibilities of arthroscopic grading are only poor to moderate. Thus, for quantitative and objective evaluation of cartilage and subchondral bone, ultrasound arthroscopy (UA) has been introduced to clarify this dilemma. Assessment of the clinical feasibility of high-frequency ultrasonography (US) during 6 knee arthroscopies was conducted, and the surgical technique is presented. US imaging was conducted with a flexible 9-MHz US catheter inserted into the joint through conventional portals. US and arthroscopy videos were synchronously recorded, and US parameters for cartilage and subchondral bone characteristics were measured. Arthroscopy and US imaging were combined to perform cartilage grading. UA produced quantitative data on lesion size, as well as cartilage quality, and showed subchondral bone changes. Visualization of an osteochondritis dissecans lesion not detected by conventional arthroscopy and US-guided retrograde drilling were possible with UA. To conclude, UA proved to be clinically feasible and aided in the diagnosis when assessing knee osteochondral lesions.

The authors report the following potential conflict of interest or source of funding: P.P. receives support from a grant for Ph.D. thesis work from the Foundation for Pediatric Research. T.V., J.S.J., and J.T. receive support from strategic funding of the University of Eastern Finland, Kuopio University Hospital (EVO grants 5041723 and 5041716); Academy of Finland (project 132367 and 267551, University of Eastern Finland); and the Spear Head Research project (Interdisciplinary, Translational Research for Improved Diagnosis and Treatment of Musculoskeletal Diseases–Musculoskeletal Research Consortium).