These include degree of repair and filling of the OL, integration to border zone, surface, structure and signal intensity of the repair tissue, aspect of the subchondral lamina and bone and presence of adhesions or effusion (CIT). The MOCART Score analyses different MRI variables that should correlate with the success of the operative management of OL lesions. However, its role in the evaluation of the treated cartilage and its clinical value are still debated. To assess and quantify possible changes after treatment, Marlovits and colleagues introduced the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score. Magnetic resonance imaging (MRI), on the other hand, allows a detailed analysis of the cartilage and does not require ionizing radiation, and has thus become a widespread tool for post-operative evaluation of the outcome of OL. Plain radiography and computed tomography are inadequate for the analysis of cartilage layers, and the ionizing radiations required are of concern. Arthroscopy remains the gold standard for the evaluation of the cartilage after treatment, but non-invasive follow-up methods are required for post-operative assessment. Several surgical techniques are available for the operative management of OL of the knee and ankle: it necessary to have reliable evaluation tools to compare the outcomes of the different techniques and offer clinically meaningful feedback to patients. Typically, these lesions lead to a decrease in daily activities from pain on weight bearing and exercise. Level of evidenceĪcute injuries, repeated strains or joint instability can produce osteochondral lesions (OL), with damage to the hyaline cartilage of the joint and to the subchondral bone. The MOCART score demonstrated no association with patient characteristics and with the surgical outcome in patients who underwent surgical management for knee and talus chondral defects. For chondral defect of the talus, no statistically significant associations were found between the MOCART score and the American Orthopedic Foot and Ankle Score ( P = 0.3), Tegner Activity Scale ( P = 0.4), visual analogue scale ( P = 0.1), rate of failure ( P = 0.1) and revision ( P = 0.7). For chondral defects of the knee, no statistically significant association was found between the MOCART score and the International Knee Documentation Committee ( P = 0.9) and with the Lysholm Knee Scoring Scales ( P = 0.2), Tegner Activity Scale ( P = 0.2), visual analogue scale P = 0.07), rate of failure ( P = 0.2) and revision ( P = 0.9).
The MOCART score evidenced no association with patient age ( P = 0.6), sex ( P = 0.1), body mass index ( P = 0.06), defect size ( P = 0.9), prior length of symptoms ( P = 0.9) or visual analogue scale ( P = 0.07). A multiple linear model regression analysis was used. A multivariate analysis was performed to assess associations between the MOCART score at last follow-up and data of patients at baseline, clinical scores and complications. MethodsĪll the studies using the MOCART score for knee and/or talus chondral defects were accessed in March 2021. The present systematic review analysed the available literature to assess reliability of the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score in the evaluation of knee and ankle osteochondral lesions.