Autogenous osteochondral "plug" transfer for the treatment of focal chondral defects: postoperative MR appearance with clinical correlation

Objective. To describe the MR appearance following autogenous osteochondral "plug" transfer for the treatment of focal chondral defects of the knee. Design and patients. Twenty-nine 1.5-T MR knee studies including dynamic ga dolinium enhancement were performed on 21 patients following autogenous ost eochondral "plug" transfer. Three musculoskeletal radiologists retrospectiv ely reviewed images to evaluate graft and donor site appearance and MR find ings were correlated with clinical outcomes. Results. MR images demonstrated graft protuberance (n=12/21; range 1-2 mm), depression (n=2/21; range I mm), and surface incongruity: mild (n=17/21), moderate (n=2/21), marked (n=1/21). The T2 signal of graft cartilage was si milar to that of adjacent cartilage in 25 of 29 examinations, and increased in four. Graft cartilage thickness relative to adjacent cartilage was < 50 % in six patients, 50-100% in 15. Graft enhancement in bone was absent at 2 weeks, but present at between 4 and 6 weeks following surgery. All patient s had clinical follow-up examinations and knee outcome survey scores were o btained in 15 patients with follow-up greater than 3 months after surgery. All patients demonstrated the expected short-term progressive clinical impr ovement. Conclusion. MR images reveal a wide range of appearances following osteocho ndral "plug" transfer. Minor variations in graft orientation and surface co ngruity do not result in adverse clinical outcome in the short term.