Objective

To assess whether subchondral drilling of acetabular cartilage flaps during femoroacetabular impingement (FAI) surgery improves (1) acetabular dGEMRIC indices and (2) morphologic magnetic resonance imaging (MRI) scores, compared with hips in which no additional treatment of cartilage lesions had been performed; and (3) whether global dGEMRIC indices and MRI scores correlate.

Design

Prospective cohort study of consecutive patients with symptomatic FAI treated with open surgery between 2000 and 2007. Patients with subchondral drilling of acetabular cartilage flaps were allocated to the study group, those without drilling to the control group. All patients underwent indirect 3-T MR arthrography to assess cartilage quality by dGEMRIC indices and a semiquantitative morphologic MRI score at minimum 5 years after surgery. dGEMRIC indices and morphologic MRI scores were compared between and among groups using analysis of covariance/paired t tests.

Results

No significant difference was found between the global dGEMRIC indices of the study group (449 ± 147 ms, 95% CI 432-466 ms) and the control group (428 ± 143 ms, 95% CI 416-442 ms; P = 0.235). In regions with cartilage flaps, the study group showed higher dGEMRIC indices (472 ± 160 ms, 95% CI 433-510 ms) compared with the control group (390 ± 122 ms, 95% CI 367-413 ms; P < 0.001). No significant differences were found for the morphologic MRI scores. A strong inversely linear correlation between the dGEMRIC indices and the morphologic MRI scores (r = −0.727, P < 0.001) was observed.

Conclusions

Treatment of acetabular cartilage flaps with subchondral drilling leads to better cartilage quality in regions with cartilage flaps at minimum 5 years of follow-up.

中文翻译：

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在至少 5 年的随访中，在股骨髋臼撞击手术中髋臼软骨瓣的软骨下钻孔后，髋关节软骨的延迟钆增强 MRI 的软骨质量得到改善。

客观的

评估股骨髋臼撞击 (FAI) 手术期间髋臼软骨瓣的软骨下钻孔是否改善 (1) 髋臼 dGEMRIC 指数和 (2) 形态磁共振成像 (MRI) 评分，与未对软骨病变进行额外治疗的髋部相比; (3) 全球 dGEMRIC 指数和 MRI 评分是否相关。

设计

对 2000 年至 2007 年期间接受开放手术治疗的连续有症状 FAI 患者的前瞻性队列研究。将髋臼软骨瓣软骨下钻孔的患者分配到研究组，将未钻孔的患者分配到对照组。所有患者在术后至少 5 年接受了间接 3-T MR 关节造影，通过 dGEMRIC 指数和半定量形态学 MRI 评分评估软骨质量。使用协方差/配对t检验分析在组间和组间比较 dGEMRIC 指数和形态学 MRI 评分。

结果

研究组的全局 dGEMRIC 指数（449 ± 147 ms，95% CI 432-466 ms）和对照组（428 ± 143 ms，95% CI 416-442 ms； P = 0.235）之间没有发现显着差异. 在有软骨瓣的区域，研究组的 dGEMRIC 指数（472 ± 160 ms，95% CI 433-510 ms）高于对照组（390 ± 122 ms，95% CI 367-413 ms；P < 0.001） . 形态学 MRI 评分未发现显着差异。观察到dGEMRIC 指数与形态学 MRI 评分之间存在强烈的负线性相关性（r = -0.727，P < 0.001）。

结论

在至少 5 年的随访中，用软骨下钻孔治疗髋臼软骨瓣可以在有软骨瓣的区域获得更好的软骨质量。