Mylène Jansen

314 Chapter 15 Another limitation of this study was that we could not separate deep and artificial cartilage, as is done often in T2-mapping studies. Many patients showed severely degenerated joints, especially in the MAC, that at times barely had cartilage left and as such did not allow for segmentation of different layers. In conclusion, treatment with KJD or HTO results in an increase in T2 relaxation times, which could indicate a progressive loss or a reorganization of collagen structure integrity. In the most severe KJD patients with indication TKA, this increase seems limited to the first year after treatment, after which the relative collagen content and structure improves. This may partly be the result of maturation of newly formed cartilage, since part of the KJD patients show a significant cartilage volume increase as well, which fits previous biochemical markers studies and animal studies on KJD.