Can the MOCART Scoring System Correlate with Patient Reported Foot and Ankle Outcome Scores After Ankle Cartilage Repair Procedures?

Autor: Taylor N. Cabe BA, Carolyn Sofka MD, Bryan Ang BA, Harry G. Greditzer MD, Sydney C. Karnovsky BA, Mark C. Drakos MD
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Zdroj: Foot & Ankle Orthopaedics, Vol 4 (2019)
Druh dokumentu: article
ISSN: 2473-0114
24730114
DOI: 10.1177/2473011419S00126
Popis: Category: Ankle, Arthroscopy, Sports Introduction/Purpose: The magnetic resonance observation of cartilage repair tissue (MOCART) scoring system was developed and modified to allow for assessment of articular cartilage repair tissue in the foot and ankle. The purpose of this study was to evaluate the intra- and inter-rater reliability of the MOCART score following a variety of surgical procedures to repair chondral injuries within the ankle joint as well as to correlate these scores to clinically relevant functional outcomes scores. By correlating functional outcome scores with each variable evaluated by the MOCART scoring system as well as the presence of edema and cysts postoperatively, we aimed to identify the radiographic parameters most closely associated with clinical outcomes. Methods: Patients treated for a chondral injury after August 2006 by a fellowship-trained foot and ankle surgeon at our institution were included if their postoperative MRI and Foot and Ankle Outcome Score (FAOS) were completed within 5 months of one another. Surgical interventions used to stimulate reparative cartilage formation included osteochondral graft transplantation, debridement, microfracture, microfracture augmented by bone marrow aspirate concentrate (BMAC), juvenile particulate cartilage implantation, or another adjunctive therapy like micronized allogenic cartilage extracellular matrix. Two radiologists (R1-R2) independently reviewed and scored each MRI using the MOCART system. A total MOCART score ranging between 0 and 100 was calculated for each patient. In addition, the presence or absence of postoperative cysts and edema was documented. Inter- and intra- rater reliability were calculated using Intraclass Correlation Coefficients (ICC), and MOCART scores were correlated with FAOS to test for relative functional and clinical relevance. Correlations were calculated as Pearson Correlation Coefficients. Results: Forty-six patients (average age 35 +/- 13.49) under the care of nine different surgeons met inclusion criteria. Average follow-up was 18 months. For overall MOCART score, intra-rater ICC = 0.87 (p
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