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동종 이식 반월상 연골의 시간적 변화 : 자기 공명 영상, 육안적, 조직학적 연구 MRI, Arthroscopic and Histologic Study
김승호,하권익,안진환,장동국 대한슬관절학회 1998 대한슬관절학회지 Vol.10 No.1
Vascular ingrowth is essential for the survial of the graft tissue. The purposes of this study were to evaluate any changes in signal intensity of cyropreserved meniscal allograft with time in the magnetic resonance images(MRI) and to demonstrate the viability of the grafts. Eight patients underwent meniscal transplantation with cryopreserved allografts using the bone block technique. MRIs of the knee were taken at 3 days, 3 weeks, 6 weeks, 3 month, 6 months, and 1 year after the implantation. A second-look arthroscopy and a small meniscal biopsy(sized 2mm x 2mm) at the peripheral and central part of the meniscus were conducted at 3 months and 1 year. Three days after the operation, the signal intensity of the implanted meniscus revealed a homogenrous low signal intensity that could not be differentiated from that of a contralateral normal meniscus. At 3 weeks, a high signal intensity appeared at the periphery of the meniscus. This signal, which did not communicate into the joint space, further intensified at 6 weeks. The high signal intensity of the meniscus, though still higher than that of the normal meniscus, decreased slightly at 3 months and continued to decrease progressively even a year after the implantation. The second-look arthroscopy revealed that the grafts were viable and that there was no tearing or shrinking of the meniscus. Cellular proliferation was also found at the central edge of the meniscus at 3 months. This cellular pattern differentiated from that of a nonmal meniscus in that the distribution of cells was not in an even, but in a clonal pattern. The cellularity after a year, however, was similar to that of normal meniscus except some area with deficiency of cells. It can be concluded that increased signal intensity of the implanted meniscus with time indicates hypervascularity caused by vascular ingrowth, similar to the high signal intensity obtained from normal meniscus in young children. Increasecl signal intensity in the chronological postoperative MRIs demonstrates the viability of the implanted cryopreserved meniscal allograft.