Shell osteochondral allografts of the knee: Comparison of MR imaging findings and immunologic responses

C. B. Sirlin, J. Brossmann, Robert D Boutin, M. N. Pathria, F. Richard Convery, W. Bugbee, R. Deutsch, L. K. Lebeck, D. Resnick

Research output: Contribution to journalArticlepeer-review

74 Scopus citations


PURPOSE: To define the magnetic resonance (MR) imaging appearance of shell osteochondral allografts of the knee and compare the MR findings with antibody responses. MATERIALS AND METHODS: Thirty-six grafts were evaluated with a 1.5-T unit with T1-, intermediate-, and T2-weighted, and three-dimensional spoiled gradient-recalled MR imaging at 3, 6, 12, 24, and/or 36 months after surgery. Nineteen patients underwent imaging serially. Two osteoradiologists scored by consensus host marrow edema, thickness of graft-host interface, signal intensity of graft marrow, cyst formation, joint effusion, articular cartilage defects, and surface collapse. Patients were divided into antibody-positive (AP) (n = 11) and antibody-negative (AN) (n = .25) groups evenly distributed across the different time points on the basis of results of anti-human leukocyte antigen antibody screening. MR findings for the two groups were compared. RESULTS: AP patients demonstrated greater mean edema (P < .002), thicker interface (P < .03), and more abnormal graft marrow (P < .04) than AN patients, and they had a higher proportion of surface collapse (P < .03). CONCLUSION: Humoral immune responses were associated with more inflammation and less complete incorporation after allograft placement. MR imaging shows promise as a surrogate biomarker for success of shell osteochondral allograft implantation.

Original languageEnglish (US)
Pages (from-to)35-43
Number of pages9
Issue number1
StatePublished - 2001


  • Antibodies
  • Bones grafts
  • Immunity
  • Knee, ligaments, menisci and cartilage
  • Knee, MR

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology


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