Insights of cartilage imaging in cartilage regeneration

doi:10.5312/wjo.v16.i7.106416

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Jul 18, 2025 (publication date) through Jul 17, 2025

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World Journal of Orthopedics

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2218-5836

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Orthop. Jul 18, 2025; 16(7): 106416
Published online Jul 18, 2025. doi: 10.5312/wjo.v16.i7.106416

Insights of cartilage imaging in cartilage regeneration

Madhan Jeyaraman, Naveen Jeyaraman, Arulkumar Nallakumarasamy, Swaminathan Ramasubramanian, Sathish Muthu

Madhan Jeyaraman, Naveen Jeyaraman, Department of Orthopaedics, ACS Medical College and Hospital, Dr MGR Educational and Research Institute, Chennai 600077, Tamil Nadu, India

Madhan Jeyaraman, Naveen Jeyaraman, Arulkumar Nallakumarasamy, Swaminathan Ramasubramanian, Sathish Muthu, Department of Regenerative Medicine, Agathisha Institute of Stemcell and Regenerative Medicine (AISRM), Chennai 600030, Tamil Nadu, India

Madhan Jeyaraman, Naveen Jeyaraman, Sathish Muthu, Department of Orthopaedics, Orthopaedic Research Group (ORG), Coimbatore 641045, Tamil Nadu, India

Arulkumar Nallakumarasamy, Department of Orthopaedics, Jawaharlal Institute of Postgraduate Medical Education and Research, Karaikal 609602, Puducherry, India

Sathish Muthu, Central Research Laboratory, Meenakshi Medical College Hospital and Research Institute, Meenakshi Academy of Higher Education and Research, Kanchipuram 631552, Tamil Nadu, India

Author contributions: Jeyaraman M and Nallakumarasamy A contributed to conceptualization; Ramasubramanian S contributed to acquiring clinical data and performing the data analysis; Jeyaraman N and Ramasubramanian S contributed to manuscript writing; Jeyaraman M, Ramasubramanian S, and Muthu S helped in manuscript revision; Muthu S contributed for image acquisition; Jeyaraman M contributed to proofreading and administration. All authors have agreed to the final version to be published and agree to be accountable for all aspects of the work.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

Corresponding author: Naveen Jeyaraman, MS, PhD, Department of Orthopaedics, ACS Medical College and Hospital, Dr MGR Educational and Research Institute, Velappanchavadi, Chennai 600077, Tamil Nadu, India. naveenjeyaraman@yahoo.com

Received: February 26, 2025
Revised: April 5, 2025
Accepted: June 24, 2025
Published online: July 18, 2025
Processing time: 142 Days and 2.6 Hours

Abstract

Cartilage, as a specialized connective tissue, underpins joint mobility and mechanical load distribution while exhibiting inherently limited self-repair capabilities. This comprehensive review redefines the current landscape of cartilage imaging by exploring conventional and advanced modalities used to assess both the structural and biochemical attributes of cartilage. Whereas conventional radiography and ultrasound offer rudimentary, indirect assessments, cutting-edge techniques - including magnetic resonance imaging (MRI)-based sequences such as T2 mapping, delayed gadolinium-enhanced MRI of cartilage, and sodium MRI - enable early detection of molecular alterations in the cartilage matrix. In addition, hybrid approaches like positron emission tomography-MRI are emerging to provide integrative molecular and structural insights. This article critically appraises imaging strategies in the context of regenerative interventions, highlighting technical innovations, persistent challenges, and future directions to facilitate improved diagnostic accuracy and therapeutic monitoring.

Keywords: Cartilage; Regeneration; Magnetic resonance imaging; Cartigram; Delayed gadolinium-enhanced magnetic resonance imaging of cartilage

Core Tip: Cartilage is crucial for joint mobility and load distribution but has limited self-repair abilities. Traditional imaging like radiography and ultrasound offer basic assessments, while advanced techniques like magnetic resonance imaging (MRI) (T2 mapping, delayed gadolinium-enhanced MRI of cartilage, sodium MRI) and hybrid positron emission tomography-MRI detect early molecular changes. This review highlights innovations, challenges, and future directions in imaging strategies for better diagnostics and regenerative intervention monitoring.