Description
- Abstract:
- Menisci are essential for long-term knee joint function. Injuries to the menisci are common. Meniscal tears are often treated with arthroscopic partial meniscectomy (PM), a common procedure in which the torn area of the meniscus is removed, while the unaffected, stable portion is left intact. A meniscal tear and its surgical treatment may place the knee at risk of developing osteoarthritis (OA) because it may disrupt the load-bearing and protective functions of the meniscus. In the case of a symptomatic meniscal tear, partial resection is routinely performed to eliminate symptoms while attempting to preserve the integrity of the articular cartilage. It is unknown, however, whether there is a critical amount of meniscal tissue that can be removed without diminishing the structure's chondroprotective function. The long-term objective of this work is to identify whether such a threshold exists by measuring the volume of meniscal tissue removed during PM and tracking OA development using quantitative magnetic resonance imaging (MRI) to assess articular cartilage thickness. In order to examine the existence of such a threshold, it is necessary to first develop non-invasive techniques to examine meniscal morphometry and articular cartilage thickness in vivo. The immediate goals of this work, therefore, were to refine, validate, and apply MR imaging-based methods for quantifying meniscal volume, and for mapping and quantifying changes in articular cartilage thickness within the tibiofemoral joint. The studies described within this dissertation provide the groundwork necessary to develop and justify a long-term prospective controlled cohort study evaluating OA following meniscal injury and PM. Such a study will influence the future care of patients undergoing surgical treatment for meniscus changes. This will be particularly important when a patient and his or her clinician choose between PM and other more complicated, expensive treatment alternatives, which may include repair, allografts, xenografts, and tissue-engineered replacements. Data from a long-term prospective study will also provide a glimpse into the changes in articular cartilage thickness that occur after injury and its surgical treatment, and may allow researchers to elucidate the mechanisms involved in post-traumatic OA development.
- Notes:
- Thesis (Ph.D. -- Brown University (2010)
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Citation
Bowers, Megan E.,
"Partial Meniscectomy and Osteoarthritis: Evaluation with Quantitative Magnetic Resonance Imaging"
(2010).
Biomedical Engineering Theses and Dissertations.
Brown Digital Repository. Brown University Library.
https://doi.org/10.7301/Z0ZG6QGT
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Biomedical Engineering Theses and Dissertations
Theses and Dissertations for the Biomedical Engineering department....