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Journal of Chinese Integrative Medicine ›› 2009, Vol. 7 ›› Issue (2): 110-115.doi: 10.3736/jcim20090203

• Original Clinical Research • Previous Articles     Next Articles

Application of magnetic resonance imaging in evaluating the effects of manipulation on knee osteoarthritis

 Jiong Hua, Ning Dub, Yong Lua, Ling-hui Daia   

  1. a Department of Traumatology, Ruijin Hospital, Medical College of Shanghai Jiaotong University, Shanghai 200025, China
    b Shanghai Pain Care Hospital, Shanghai 200025, China
  • Received:2008-08-28 Accepted:2008-10-20 Online:2009-02-20 Published:2009-02-15

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Objective

To observe and evaluate the effects of manipulation on knee osteoarthritis (KOA) using T2-mapping and magnetic resonance imaging (MRI)-based volume measurements.
Methods

Forty-five cases of KOA were involved retrospectively in the study, and the patients were composed of 9 males and 36 females with the mean age of (57.4±6.1) years. The cases were treated with manipulative therapy once or twice per week for 12 months. MRI of each knee was performed separately by using 1.5-T MRI equipment before and during the treatment. Average cartilage depth, MRI grading of cartilage defects, cartilage volume, average T2 values in patella cartilage and femoral condyle, and bone marrow edema area were detected respectively.
Results

The knee joint cartilage thickness from MRI began to increase after 6-month treatment (P<0.05). The cartilage volume increase was obviously observed after 12-month treatment, and there was a significant difference (F=14.64, P<0.01). MRI grading of cartilage defects decreased from ⅢA to ⅡB after 3-month treatment (Z=17.96, P<0.05). The average T2 value in patella cartilage decreased after 9-month treatment (F=3.11, P<0.05), but there were no differences in cartilage from tibial plateau and femoral condyle compartments after the treatment. The bone marrow edema area in femoral condyle began to diminish at 3-month treatment (t=–4.53, P<0.01), and the bone marrow edema area in cartilage patella was diminished after 6-month treatment (t=–5.53, P<0.01).
Conclusion

T2-mapping and cartilage volume measurement are suitable for evaluating the manipulative therapy on KOA. Traditional Chinese manipulation therapy is an effective method for KOA in the cartilage recovery.

Key words: Knee joint, Osteoarthritis, Musculoskeletal manipulations, Nuclear magnetic resonance

Table 1

Changes of MRI parameters before and after treatment (x±s)"

Treatment time n MRI parameters
Cartilage
volume (cm3)		 MRI grading
of cartilage
defects		 Average T2
value in patella
cartilage (ms)		 Average T2
value in femoral
condyle (ms)		 Bone marrow
edema area in femur
cartilage (cm2)		 Bone marrow edema
area in patella
cartilage (cm2)
Before treatment 45 96.76±12.99 3.80±0.91 36.42±3.01 36.14±3.56 5.80±0.93 3.96±0.82
Three months 45 98.18±14.48 3.34±0.86* 35.82±3.38 36.86±3.19 4.08±3.70* 3.46±0.34
Six months 45 104.36±11.24 3.28±0.98* 35.70±2.90 35.95±1.18 3.22±0.56* 2.01±0.11*
Nine months 45 109.32±13.45 3.15±0.78* 32.18±2.37* 35.69±2.44 2.95±0.37* 1.92±0.76*
Twelve months 45 122.06±29.80* 3.12±0.97* 31.77±2.33* 35.46±1.17 2.63±0.65* 1.55±0.85*

Figure 1

Changes of MRI cartilage volume before and after treatment A: Before treatment; B: Three-month treatment; C: Six-month treatment; D: Nine-month treatment; E: Twelve-month treatment."

Figure 2

Changes of MRI cartilage volume before and after treatment A: Before treatment; B: Three-month treatment; C: Six-month treatment; D: Nine-month treatment; E: Twelve-month treatment."

Figure 3

Changes of bone marrow edema before and after treatment A: Before treatment; B: Three-month treatment; C: Six-month treatment. White arrowhead demonstrated the location of bone marrow edema in patella. After 6-month treatment the areas of bone marrow edema obviously diminished or disappeared."

[1] Du N, Shi RT . Clinical observation of manipulation in treating 37 cases of primary knee osteoarthritis[J]. Zhong Yi Zheng Gu, 1994,6(4):9-11
杜宁, 施荣庭 . 手法治疗原发性膝关节骨关节病37例疗效观察[J]. 中医正骨, 1994,6(4):9-11
[2] Dunn TC, Lu Y, Jin H, Ries MD, Majumdar S . T2 relaxation time of cartilage at MR imaging: comparison with severity of knee osteoarthritis[J]. Radiology, 2004,232(2):592-598
doi: 10.1148/radiol.2322030976
[3] Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K, Christy W, Cooke TD, Greenwald R, Hochberg M, Howell D, Kaplan D, Koopman W, Longley S, Mankin H, Mcshane DJ, Medsger TJR, Meenan R, Mikkelsen W, Moskowitz R, Murphy W, Rothschild B, Segal M, Sokoloff L, Wolfe F . Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association[J]. Arthritis Rheum, 1986,29(8):1039-1049
doi: 10.1002/(ISSN)1529-0131
[4] Recht MP, Kramer J, Marcelis S, Pathria MN, Trudell D, Haghighi P, Sartoris DJ, Resnick D . Abnormalities of articular cartilage in the knee: analysis of available MR techniques[J]. Radiology, 1993,187(2):473-478
doi: 10.1148/radiology.187.2.8475293
[5] Watanab A, Wada Y, Obata T, Ueda T, Tamura M, Ikehira H, Moriya H . Delayed gadolinium-enhanced MR to determine glycosaminoglycan concentration in reparative cartilage after autologous chondrocyte implantation: preliminary results[J]. Radiology, 2006,239(1):201-208
doi: 10.1148/radiol.2383050173
[6] Watrin A, Ruaud JP, Olivier PT, Guingamp NC, Gonord PD, Netter PA, Blum AG, Guillot GM, Gillet PM, Loeuille DH . T2-mapping of rat patellar cartilage[J]. Radiology, 2001,219(2):395-402
doi: 10.1148/radiology.219.2.r01ma32395
[7] Link TM, Steinbach IS, Ghosh S, Ries M, Lu Y, Lane N, Majumdar S . Osteoarthritis: MR imaging findings in different stages of disease and correlation with clinical findings[J]. Radiology, 2003,226(2):373-381
doi: 10.1148/radiol.2262012190
[8] Wang JW, Du N, Fu SC, Shi WB, Qu KF, Li GH . Study on treatment for experimental knee osteoarthritis with massage[J]. Shanghai Di Er Yi Ke Da Xue Xue Bao, 1996,16(6):417-419
王济纬, 杜宁, 符诗聪, 史炜镔, 曲克服, 李国衡 . 手法治疗实验性膝骨关节炎研究[J]. 上海第二医科大学学报, 1996,16(6):417-419
[9] Verstraete KL, Almqvist F, Verdonk P , Vanders-chueren G, Huysse W, Verdonk R, Verbrugge G.Magnetic resonance imaging of cartilage and cartilage repair[J]. Clin Radiol, 2004,59(8):674-689
doi: 10.1016/j.crad.2004.01.012
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