A systematic review demonstrating correlation of MRI compositional parameters with clinical outcomes following articular cartilage repair interventions in the knee

Beth Lineham; Harin Wijayathunga; Emma Moran; Farag Shuweihdi; Harun Gupta; Hemant Pandit; Nagitha Wijayathunga

doi:10.1016/j.ocarto.2023.100388

A systematic review demonstrating correlation of MRI compositional parameters with clinical outcomes following articular cartilage repair interventions in the knee

Osteoarthr Cartil Open. 2023 Jul 28;5(3):100388. doi: 10.1016/j.ocarto.2023.100388. eCollection 2023 Sep.

Authors

Beth Lineham¹, Harin Wijayathunga², Emma Moran³, Farag Shuweihdi⁴, Harun Gupta³, Hemant Pandit¹, Nagitha Wijayathunga⁵

Affiliations

¹ Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, UK.
² University of Edinburgh, Edinburgh, UK.
³ Leeds Teaching Hospitals NHS Trust, Leeds, UK.
⁴ Department of Statistics, University of Leeds, UK.
⁵ Institute of Medical and Biological Engineering, University of Leeds, UK.

Abstract

Objective: Compositional-MRI parameters enable the assessment of cartilage ultrastructure. Correlation of these parameters with clinical outcomes is unclear. This systematic review investigated the correlation of various compositional- MRI parameters with clinical outcome measures following cartilage repair or regeneration interventions in the knee.

Design: This study was registered with PROSPERO and reported in accordance with PRISMA. PubMed, Institute of Science Index, Scopus, Cochrane Central Register of Controlled Trials, and Embase databases were searched. All studies, regardless of type, that presented correlation of compositional- MRI parameters with clinical outcome measures were included. Two researchers independently performed data extraction and QUADAS-2 analysis. Compositional-MRI parameter change following intervention and correlation with clinical outcome measures were evaluated.

Results: 19 studies were included. Risk of bias was generally low. 5 different compositional parameters were observed from the included studies. However, due to the significant variability in the reporting of compositional-MRI parameters across studies, meta-analyses were possible only for T2 values and T2 index values (T2 value of repair cartilage relative to normal cartilage). Correlation of T2 values of repair cartilage with clinical outcome score was r = 0.33 [0.15, 0.52]. Correlation of T2 index with clinical outcome score was r = 0.52 [0.32, 0.77].

Conclusions: Correlation between T2 values and clinical outcome scores following knee cartilage repair were found. The heterogeneity of the correlations extracted from the included studies limited the scope for the meta-analysis. Thus, standardised, high-quality studies are required for better assessment of correlation between compositional MRI parameters and clinical outcome measures after cartilage repair.

Registration number: PROSPERO CRD42021287364.Study protocol available on PROSPERO website.

Keywords: Cartilage repair; Clinical outcomes; Compositional MRI; Knee cartilage; MR relaxometry; Osteoarthritis; Outcome scores; Quantitative MRI; T2 mapping.

Publication types

Review