Does the dGEMRIC Index Recover 3 Years After Surgical FAI Correction and an Initial dGEMRIC Decrease at 1-Year Follow-up? A Controlled Prospective Study

Malin Kristin Meier; Samira Scheuber; Markus Simon Hanke; Pascal Cyrill Haefeli; Adrian Cyrill Ruckli; Emanuel Francis Liechti; Nicolas Gerber; Till Dominic Lerch; Moritz Tannast; Klaus Arno Siebenrock; Simon Damian Steppacher; Florian Schmaranzer

doi:10.1177/03635465231167854

Does the dGEMRIC Index Recover 3 Years After Surgical FAI Correction and an Initial dGEMRIC Decrease at 1-Year Follow-up? A Controlled Prospective Study

Am J Sports Med. 2023 Jun;51(7):1808-1817. doi: 10.1177/03635465231167854. Epub 2023 May 15.

Affiliations

¹ Department of Orthopaedic Surgery and Traumatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
² Department of Orthopaedic and Trauma Surgery, Lucerne Cantonal Hospital, Lucerne, Switzerland.
³ Personalized Medicine Research, School of Biomedical and Precision Engineering, University of Bern, Bern, Switzerland.
⁴ Department of Diagnostic, Interventional and Paediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
⁵ Department of Orthopaedic Surgery and Traumatology, Fribourg Cantonal Hospital, University of Fribourg, Fribourg, Switzerland.

PMID: 37183998
DOI: 10.1177/03635465231167854

Abstract

Background: Delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) allows objective and noninvasive assessment of cartilage quality. An interim analysis 1 year after correction of femoroacetabular impingement (FAI) previously showed that the dGEMRIC index decreased despite good clinical outcome.

Purpose: To evaluate dGEMRIC indices longitudinally in patients who underwent FAI correction and in a control group undergoing nonoperative treatment for FAI.

Study design: Cohort study; Level of evidence, 3.

Methods: This prospective, comparative longitudinal study included 39 patients (40 hips) who received either operative (n = 20 hips) or nonoperative (n = 20 hips) treatment. Baseline demographic characteristics and presence of osseous deformities did not differ between groups. All patients received indirect magnetic resonance arthrography at 3 time points (baseline, 1 and 3 years of follow-up). The 3-dimensional cartilage models were created using a custom-developed deep learning-based software. The dGEMRIC indices were determined separately for acetabular and femoral cartilage. A mixed-effects model was used for statistical analysis in repeated measures.

Results: The operative group showed an initial (preoperative to 1-year follow-up) decrease of dGEMRIC indices: acetabular from 512 ± 174 to 392 ± 123 ms and femoral from 530 ± 173 to 411 ± 117 ms (both P < .001). From 1-year to 3-year follow-up, dGEMRIC indices improved again: acetabular from 392 ± 123 to 456 ± 163 ms and femoral from 411 ± 117 to 477 ± 169 ms (both P < .001). The nonoperative group showed no significant changes in dGEMRIC indices in acetabular and femoral cartilage from baseline to either follow-up point (all P > .05).

Conclusion: This study showed that 3 years after FAI correction, the dGEMRIC indices improved compared with short-term 1-year follow-up. This may be due to normalized joint biomechanics or regressive postoperative activation of the inflammatory cascade after intra-articular surgery.

Keywords: MRI; dGEMRIC; femoroacetabular impingement; hip.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cartilage, Articular* / diagnostic imaging
Cartilage, Articular* / pathology
Cartilage, Articular* / surgery
Cohort Studies
Contrast Media
Femoracetabular Impingement* / diagnostic imaging
Femoracetabular Impingement* / pathology
Femoracetabular Impingement* / surgery
Follow-Up Studies
Gadolinium
Hip Joint / surgery
Humans
Longitudinal Studies
Magnetic Resonance Imaging / methods
Prospective Studies

Substances

Gadolinium
Contrast Media