dGEMRIC assessment of hip articular cartilage in hips undergoing hip preservation
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Abstract
BACKGROUND: Hip osteoarthritis can present an individual with many challenges, including limited range of motion, impaired gait mechanics, pain, and diminished quality of life. In patients who are at increased risk of developing hip osteoarthritis, such as those with abnormal morphology of the hip, hip preservation surgery can be used to prolong the life of a patient’s natural hip. One such example of this hip preservation surgery is known as the periacetabular osteotomy. The periacetabular osteotomy has shown promise in prolonging the patient’s natural hip and slowing the progression of osteoarthritis, however, there has been variable results on who should undergo the procedure. Preexisting osteoarthritis has been shown to affect the efficacy of the procedure and dGEMRIC is known to measure the severity of preexisting osteoarthritis.
OBJECTIVE: Our study aimed to validate dGEMRIC as a potential preoperative measure to predict the failure or success of PAO and it’s value as a tool to select which patients to undergo hip preservation surgery.
METHODS: A retrospective study of 70 preoperative hips was performed on patients who were undergoing a periacetabular osteotomy procedure. The dGEMRIC index values for the whole cartilage structure were measured for a total of 70 hips. In addition, for 29 3D-dimensional hips, the whole cartilage segmentation was divided into subregions. The dGEMRIC index values for these subregions were also measured. In addition, the cartilage thickness values for the 3D-dimensional hips were taken as well. Data analysis was completed to identify a potential relationship between the index/thickness measurements and failure/success of PAO.
RESULTS: For the whole cartilage analysis, there was a statiscally significant difference for the survival of hips that had a dGEMRIC index above 400 ms and failure of hips that had an index value below 400 ms (p < 0.001). The differences in failure and survival for the cartilage subregions were also statistically significant. The thickness values for failure and survival did not produce statistically significant results.
CONCLUSION: Because of dGEMRIC’s ability to provide a measure of the severity of preexisting osteoarthritis, it can be used as preoperative predictor of the success of hip preservation surgery and can be useful in clinical and surgical decision making.
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Attribution 4.0 International