dGEMRIC as a tool for measuring changes in cartilage quality following high tibial osteotomy: a feasibility study

Abstract

dGEMRIC effectively detected differences in cartilage quality within knee compartments before and after HTO, but no changes due to HTO were detected. Hardware removal post-HTO seems essential for adequate T(1)Gd interpretation. T(1)Gd was correlated to improved clinical scores on a subscore level only. Longer follow-up after HTO may reveal lasting changes. ClinicalTrials.gov registration ID: NCT01269944.

Cartilage health in high tibial osteotomy using dGEMRIC: Relationships with joint kinematics

“…Parker et al studied tibiofemoral cartilage after opening-wedge HTO at 3 T and found no statistically significant differences in tibiofemoral cartilage dGEMRIC score between the pre-op (medial 562 ms, lateral 628 ms; n = 10), six months (medial 507 ms, lateral 588 ms) and one year post-op (medial 516 ms, lateral 582 ms) states [13]. Rutgers' study of opening-wedge HTO performed at 1.5 T found no significant differences between pre-and post-operative dGEMRIC (n = 10, preop 533 ms, post-op (~12 months) 466 ms) [14], although the values are not directly comparable to those measured at 3 T. The dGEMRIC scores in our study were within with the range of 400-900 ms mean dGEMRIC T 1 value reported by McKenzie et al in a study at 3 T [20]. Large variability in dGEMRIC score between individuals, similar to that seen in this study, has been previously observed.…”

“…Delayed gadoliniumenhanced magnetic resonance imaging, MRI of cartilage (dGEMRIC), a validated method for estimating GAG content of cartilage, in vivo, using T 1 mapping [12], represents a minimally invasive method to assess articular cartilage. Recent studies of cartilage health in HTO have applied dGEMRIC to TF cartilage before and after surgery [13,14], but have not been applied to the patella. In each case, they found no significant difference in overall TF dGEMRIC score with HTO and found no correlation between changes in dGEMRIC score and changes in two dimensional (2D) leg alignment [13,14].…”

“…Recent studies of cartilage health in HTO have applied dGEMRIC to TF cartilage before and after surgery [13,14], but have not been applied to the patella. In each case, they found no significant difference in overall TF dGEMRIC score with HTO and found no correlation between changes in dGEMRIC score and changes in two dimensional (2D) leg alignment [13,14]. However, it is not clear whether there is a relationship between changes in cartilage health as assessed with dGEMRIC and changes in three dimensional (3D) knee kinematics following surgery.…”

Imaging Strategies for Assessing Cartilage Composition in Osteoarthritis

“…It has been used to distinguish between healthy and diseased cartilage in the hip [25, 26], finger [27], and knee joints [28]. dGEMRIC T 1 relaxation times have been used as outcome measures following surgical intervention in both the knee and ankle [29–31] and are predictive of progression to late-stage OA [32]. …”

CORR Insights®: The Value of Valgus Stress Radiographs in the Workup for Medial Unicompartmental Arthritis

“…Currently, MRI can be considered the most effective imaging tool for cartilage evaluation [1,2]. Recent advances in MRI, such as dGEMRIC, T1qmapping, and T2 mapping, are useful for examining cartilage integrity.…”