Anterior Delayed Gadolinium-enhanced MRI of Cartilage Values Predict Joint Failure After Periacetabular Osteotomy

Kim, Sang Do; Jessel, Rebecca H.; Zurakowski, David; Millis, Michael B.; Kim, Young-Jo

doi:10.1007/s11999-012-2519-9

Cited by 49 publications

(47 citation statements)

References 70 publications

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“…Hasegawa et al [9] described four factors leading to a poor outcome: a small (\2 mm) preoperative minimum joint space, joint congruency, simultaneous intertrochanteric valgus osteotomy, and lateral subluxation of the femoral head postoperatively. Regarding joint congruency, several authors emphasized that postoperative good joint congruency is essential for a favorable outcome after periacetabular osteotomy and rotational acetabular osteotomy [11][12][13]. Patients with previous surgery or who need simultaneous femoral osteotomy are at risk of unfavorable postoperative joint congruency, and favorable long-term results cannot be expected.…”

Section: Discussionmentioning

confidence: 99%

Rotational Acetabular Osteotomy for Pre- and Early Osteoarthritis Secondary to Dysplasia Provides Durable Results at 20 Years

Yasunaga

Ochi

Yamasaki

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Hip dysplasia is a common cause of secondary osteoarthritis (OA). Periacetabular osteotomy or rotational acetabular osteotomy has been used as jointpreserving procedures. However, only a few reports of long-term results with these operations have been reported. Questions/purposes (1) Would satisfactory clinical and radiographic outcomes be maintained at a mean duration of 20 years after rotational acetabular osteotomy for pre-and early-stage OA; and (2) could we identify risk factors for radiographic progression of OA?Methods Between 1987 and 2001, we treated 159 patients (173 hips) with rotational acetabular osteotomies for the diagnosis of pre-OA or early-stage OA according to the technique of Ninomiya and Tagawa. During that period, our general indications for this approach were age younger than 60 years, center-edge angle less than 20°, and improved femoral head coverage and joint congruency on preoperative AP plain radiographs of the hip in abduction; we did not use this approach when joint congruency was not improved or no widening of the joint space was noted on preoperative AP plain radiographs of the hip in abduction. Of those patients, 21 patients with pre-OA (followup rate: 84% [27 hips]) and 110 patients in the early-stage group (followup rate: 82% [118 hips]) were available at a minimum of 15 years for a total patient group of 131 (followup rate: 82% [145 hips]). The mean age at the time of surgery was 22 years in the pre-OA group and 38 years in the early-stage group. The mean followup was 21 years in the pre-OA group and 20 years in the earlystage group. Clinical evaluation was performed with the Merle d'Aubigne and Postel rating scale, and radiographic analyses included measurements of the center-edge angle, acetabular roof angle, and head lateralization index on preoperative and postoperative AP radiographs of the pelvis. Postoperative joint congruency was also evaluated. The cumulative probabilities of radiographic signs of OA progression were estimated with use of the Kaplan-Meier product-limited method and parametric survivorship analysis using the Cox proportional-hazards model was used to determine risk factors for radiographic OA progression. Results The mean clinical score improved very slightly, from 15 (SD, 0.8) to 18 (SD, 1.1) (95% confidence interval [CI], À2.9 to À2.0; p \ 0.001) in the pre-OA group and from 15 (SD, 1.0) to 16 (SD, 2.1) (95% CI, À2.0 to À1.2; p \ 0.001) in the early-stage group at followup. Fourteen

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Section: Discussionmentioning

confidence: 99%

Rotational Acetabular Osteotomy for Pre- and Early Osteoarthritis Secondary to Dysplasia Provides Durable Results at 20 Years

Yasunaga

Ochi

Yamasaki

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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“…This confirms that hip OA in acetabular dysplasia is a condition that affects the entire joint. On account of regional variations in the biochemical composition in dysplastic hips, Kim et al questioned whether the dGEMRIC index of the anterior joint would better predict a premature joint failure after a Bernese PAO than the previously reported coronal dGEMRIC index [51]. They reviewed 43 hips in 41 patients who underwent a Bernese PAO for hip dysplasia (follow-up ranged from 24 to 46 months).…”

Section: Previous Work Dgemric In Hip Dysplasiamentioning

confidence: 99%

Current knowledge and importance of dGEMRIC techniques in diagnosis of hip joint diseases

et al. 2015

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Accurate assessment of early hip joint cartilage alterations may help optimize patient selection and follow-up of hip joint preservation surgery. Delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) is sensitive to the glycosaminoglycan content in cartilage that is lost early in the development of osteoarthritis (OA). Hence, the dGEMRIC technique holds promise for the development of new diagnostic and therapeutic procedures. However, because of the location of the hip joint deep within the body and due to the fairly thin cartilage layers that require high spatial resolution, the diagnosis of early hip joint cartilage alterations may be problematic. The purpose of this review is to outline the current status of dGEMRIC in the assessment of hip joint cartilage. A literature search was performed with PubMed, using the terms "cartilage, osteoarthritis, hip joint, MRI, and dGEMRIC", considering all levels of studies. This review revealed that dGEMRIC can be reliably used in the evaluation of early stage cartilage pathology in various hip joint disorders. Modifications in the technique, such as the operation of three-dimensional imaging and dGEMRIC after intra-articular contrast medium administration, have expanded the range of application. Notably, the studies differ considerably in patient selection and technical prerequisites. Furthermore, there is a need for multicenter prospective studies with the required technical conditions in place to establish outcome based dGEMRIC data to obtain, in conjunction with clinical data, reliable threshold values for normal and abnormal cartilage, and for hips that may benefit from conservative or surgical treatment.

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“…One technique, delayed gadolinium-enhanced MRI of cartilage (dGEMRIC), correlates with histological markers of early-stage OA [4] and pain symptoms associated with DDH and FAI [11,13]. In hips with DDH, dGEMRIC also correlates with the severity of dysplasia and can predict premature joint failure after treatment with PAO [8,12,13]. Briefly, glycosaminoglycans (GAG) constitute a major portion of the matrix in cartilage and hold a strongly negative charge.…”

Section: Introductionmentioning

confidence: 99%

Planar dGEMRIC Maps May Aid Imaging Assessment of Cartilage Damage in Femoroacetabular Impingement

Bulat

Bixby

Siversson

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Three-dimensional (3-D) delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) helps quantify biochemical changes in articular cartilage that correlate with early-stage osteoarthritis. However, dGEMRIC analysis is performed slice by slice, limiting the potential of 3-D data to give an overall impression of cartilage biochemistry. We previously developed a computational algorithm to produce unfolded, or ''planar,'' dGEMRIC maps of acetabular cartilage, but have neither assessed their application nor determined whether MRI-based grading of cartilage damage or dGEMRIC measurements predict intraoperative findings in hips with symptomatic femoroacetabular impingement (FAI). Questions/purposes (1) Does imaging-based assessment of acetabular cartilage damage correlate with intraoperative findings in hips with symptomatic FAI? (2) Does the planar dGEMRIC map improve this correlation? (3) Does the planar map improve the correlation between the dGEMRIC index and MRI-based grading of cartilage damage in hips with symptomatic FAI? (4) Does the planar map improve imaging-based evaluation time for hips with symptomatic FAI? Methods We retrospectively studied 47 hips of 45 patients with symptomatic FAI who underwent hip surgery between 2009 and 2013 and had a 1.5-T 3-D dGEMRIC scan within 6 months preoperatively. Our cohort included 25 males and 20 females with a mean ± SD age at surgery of 29 ± 11 years. Planar dGEMRIC maps were generated from isotropic, sagittal oblique TrueFISP and T1 sequences. A pediatric musculoskeletal radiologist with experience in hip MRI evaluated studies using radially reformatted sequences. 123Clin Orthop Relat Res (2016) 474:467-478 DOI 10.1007 Clinical Orthopaedics and Related Research ® A Publication of The Association of Bone and Joint Surgeons® map and 13 without the map, and total evaluation times were recorded. Results There were no meaningful differences in the correlations obtained with versus without referencing the planar maps. Planar map-independent Outerbridge grades had a notable (p \ 0.05) Spearman's rank correlation (q) with Beck's grades that was moderate in AP, SC, and PC (0.3\q \ 0.5) and strong in SP (q [ 0.5). For map-dependent Outerbridge grades, q was moderate in AP, AC, and SC and strong in SP. Map-independent dGEMRIC indices had a q with Beck's grades that was moderate in AP and SC (À0.3[ q [ À0.5) and strong in SP (q \ À0.5). For map-dependent dGEMRIC indices, q was moderate in SC and strong in SP. Similarly, there were no meaningful, map-dependent differences in the correlations. When comparing Outerbridge grades and dGEMRIC indices, there were notable correlations across all subregions. Without the planar map, q was moderate in AC and PC and strong in AP, SP, SC, and PP. With the map, q was strong in all six subregions. In AC, there was a notable map-dependent improvement in this correlation (p \ 0.001). Finally, referencing the planar dGEMRIC map during evaluation was associated with a decrease in mean evaluation time, from 207 ± 32 seconds to 152 ±...

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Anterior Delayed Gadolinium-enhanced MRI of Cartilage Values Predict Joint Failure After Periacetabular Osteotomy

Abstract: Background Several available compositional MRIs seem to detect early osteoarthritis before radiographic appearance.

Cited by 49 publications

References 70 publications

Rotational Acetabular Osteotomy for Pre- and Early Osteoarthritis Secondary to Dysplasia Provides Durable Results at 20 Years

Rotational Acetabular Osteotomy for Pre- and Early Osteoarthritis Secondary to Dysplasia Provides Durable Results at 20 Years

Current knowledge and importance of dGEMRIC techniques in diagnosis of hip joint diseases

Planar dGEMRIC Maps May Aid Imaging Assessment of Cartilage Damage in Femoroacetabular Impingement

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