Time-Resolved Quantification of Patellofemoral Cartilage Deformation in Response to Loading and Unloading via Dynamic MRI With Prospective Motion Correction

Background: In vivo cartilage deformation has been studied by static magnetic resonance imaging (MRI) with in situ loading, but knowledge about strain dynamics after load onset and release is scarce. Purpose: To measure the dynamics of patellofemoral cartilage deformation and recovery in response to in situ loading and unloading by using MRI with prospective motion correction. Study Type: Prospective. Subjects: Ten healthy male volunteers (age: [31.4 +/- 3.2] years). Field Strength/Sequence: T1-weighted RF-spoiled 2D gradient-echo sequence with a golden angle radial acquisition scheme, augmented with prospective motion correction, at 3 T. Assessment: In situ knee loading was realized with a flexion angle of approximately 40 degrees using an MR-compatible pneumatic loading device. The loading paradigm consisted of 2 minutes of unloaded baseline followed by a 5-minute loading bout with 50% body weight and an unloading period of 38 minutes. The cartilage strain was assessed as the mean distance between patellar and femoral bone-cartilage interfaces as a percentage of the initial (pre-load) distance. Statistical Tests: Wilcoxon signed-rank tests (significance level: P < 0.05), Pearson correlation coefficient (r). Results: The cartilage compression and recovery behavior was characterized by a viscoelastic response. The elastic compression ([+/- 12.5 +/- 3.1]%) was significantly larger than the viscous compression ([+/- 7.6 +/- 1.5]%) and the elastic recovery ([10.5 +/- 2.1]%) was significantly larger than the viscous recovery ([6.1 +/- 1.8]%). There was a significant residual offset strain ([+/- 3.6 +/- 2.3]%) across the cohort. A significant negative correlation between elastic compression and elastic recovery was observed (r = +/- 0.75). Data Conclusion: The in vivo cartilage compression and recovery time course in response to loading was successfully measured via dynamic MRI with prospective motion correction. The clinical relevance of the strain characteristics needs to be assessed in larger subject and patient cohorts. Level of Evidence: 2 Technical Efficacy: Stage 1

Automated summary

This study measured the dynamics of patellofemoral cartilage deformation and recovery in response to in situ loading and unloading using MRI. The results showed a viscoelastic response of the cartilage, with larger elastic compression and recovery compared to viscous compression and recovery. There was also a significant residual offset strain across the cohort, and a negative correlation between elastic compression and elastic recovery.