Background:

Delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) is an advanced imaging technique that is purported to quantify cartilage damage in acute and chronic joint disease and predict periacetabular osteotomy (PAO) outcomes. There is a paucity of literature relating dGEMRIC values to arthroscopic findings before PAO and postoperative outcomes after PAO.

Purpose:

To assess the utility and validity of dGEMRIC as a preoperative and prognostic assessment tool of cartilage status and integrity as it relates to intraoperative findings and midterm postoperative outcomes after PAO.

Study Design:

Case series; Level of evidence, 4.

Methods:

We analyzed a cohort of 58 patients (70 hips) with a median age of 30.1 years (range, 15-50) with hip dysplasia who underwent hip arthroscopy, followed by a PAO with preoperative dGEMRIC. The primary outcome measures were intraoperative assessment and correlation with cartilage damage (presence of cartilage flap, Outerbridge grade of the acetabulum and femoral head). Secondary outcome measures were postoperative patient-reported outcome (PRO) scores, including the International Hip Outcome Tool and Non-arthritic Hip Score. Correlation analyses were performed to determine the relationship between dGEMRIC values and (1) PROs and (2) intraoperative assessment of cartilage damage.

Results:

There were significant negative linear relationships between dGEMRIC values and the primary outcome measures: presence of a cartilage flap (coronal, P = .004; sagittal, P < .001), Outerbridge grade of acetabular articular cartilage lesion (coronal, P = .002; sagittal, P = .003), and Outerbridge grade of femoral head articular cartilage lesion (coronal, P = .001; sagittal, P < .001). Despite significant overall improvement in all patients, there was no significant correlation between preoperative dGEMRIC values and improvement in PROs from presurgery to latest postoperative follow-up (median, 2.2 years; range, 1.0-5.0 years).

Conclusion:

Although dGEMRIC values (sagittal and coronal) were significant predictors of the intraoperative presence of cartilage flaps and overall cartilage integrity, they were not associated with midterm outcomes after PAO.

中文翻译：

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延迟钆增强 MRI 软骨 (dGEMRIC) 值与髋关节镜术中发现和中期髋臼周围截骨术结果的相关性

背景：

软骨延迟钆增强磁共振成像 (dGEMRIC) 是一种先进的成像技术，旨在量化急性和慢性关节疾病中的软骨损伤并预测髋臼周围截骨术 (PAO) 的结果。很少有文献将 dGEMRIC 值与 PAO 前的关节镜检查结果和 PAO 后的术后结果相关联。

目的：

评估 dGEMRIC 作为软骨状态和完整性的术前和预后评估工具的效用和有效性，因为它与 PAO 后的术中发现和术后中期结果有关。

学习规划：

案例系列；证据水平，4。

方法：

我们分析了 58 名中位年龄为 30.1 岁（范围 15-50 岁）的髋关节发育不良患者（70 髋），他们接受了髋关节镜检查，然后是 PAO 和术前 dGEMRIC。主要结果测量是术中评估和与软骨损伤的相关性（软骨瓣的存在、髋臼和股骨头的 Outerbridge 等级）。次要结果指标是术后患者报告结果 (PRO) 评分，包括国际髋关节结果工具和非关节炎髋关节评分。进行相关性分析以确定 dGEMRIC 值与 (1) PRO 和 (2) 软骨损伤的术中评估之间的关系。

结果：

dGEMRIC 值与主要结果测量值之间存在显着的负线性关系：存在软骨瓣（冠状面，P = .004；矢状面，P < .001），髋臼关节软骨损伤的外桥等级（冠状面，P = .002 ；矢状，P = .003）和股骨头关节软骨损伤的 Outerbridge 等级（冠状，P = .001；矢状，P < .001）。尽管所有患者的总体改善显着，但术前 dGEMRIC 值与从术前到最近的术后随访（中位数，2.2 年；范围，1.0-5.0 年）的 PROs 改善之间没有显着相关性。

结论：

尽管 dGEMRIC 值（矢状和冠状）是术中存在软骨瓣和整体软骨完整性的重要预测因子，但它们与 PAO 后的中期结果无关。