Insights of cartilage imaging in cartilage regeneration

Table 3 Integration of imaging with regenerative strategies - diagnostic and prognostic markers

Regenerative strategy	Imaging modalities utilized	Key imaging biomarkers	Prognostic implications	Future research directions
Microfracture	Morphological MRI; T2 mapping; dGEMRIC	Uniformity and integration of repair tissue; quantitative T2 changes	Early functional gains may be offset by the long-term vulnerability of fibrocartilage	Refinement of imaging protocols to differentiate fibrocartilage from hyaline-like repair tissue
Osteochondral autograft transplantation	Morphological MRI; CT arthrography; high-resolution 3D sequences	Graft congruence; signal homogeneity at the graft-host interface	Potential donor-site morbidity; risk of graft fragmentation or subchondral cyst formation	Development of predictive imaging markers for long-term graft viability and mechanical integration
Osteochondral allograft transplantation	MRI; CT arthrography; T1ρ imaging	Viability of transplanted tissue; early biochemical alterations at the graft interface	Time-sensitive graft viability; immunological responses and delayed integration	Advanced imaging for real-time monitoring of graft immune response and viability
Matrix-induced autologous chondrocyte implantation	High-resolution MRI; T2/T1ρ mapping; dGEMRIC	Restoration of native signal intensity; uniformity in repair tissue; quantitative GAG levels	Risk of graft overgrowth; potential for revision surgery due to suboptimal integration	Standardization of imaging biomarkers to predict early signs of graft failure and guide intervention timing
Particulated juvenile allograft cartilage	3D MRI sequences; T1ρ imaging; sodium MRI	Homogeneity of the repair tissue; integration with adjacent native cartilage; proteoglycan consistency	Uncertain long-term integration dynamics; variable repair tissue maturation	Longitudinal imaging studies correlating early imaging biomarkers with clinical outcomes

MRI: Magnetic resonance imaging; dGEMRIC: Delayed gadolinium-enhanced magnetic resonance imaging of cartilage; CT: Computed tomography; 3D: Three-dimensional; GAG: Glycosaminoglycan.