scholarly journals Magnetic resonance imaging of hip joint cartilage and labrum

2011 ◽  
Vol 3 (2) ◽  
pp. 9 ◽  
Author(s):  
Christoph Zilkens ◽  
Falk Miese ◽  
Marcus Jager ◽  
Bernd Bittersohl ◽  
Rüdiger Krauspe
Keyword(s):  
Surgical Procedures ◽  
Hip Joint ◽  
Hip Dysplasia ◽  
Periacetabular Osteotomy ◽  
Cartilage Damage ◽  
Joint Damage ◽  
Hip Dislocation ◽  
Resonance Imaging ◽  
Surgical Hip Dislocation ◽  
Hip Anatomy

Hip joint instability and impingement are the most common biomechanical risk factors that put the hip joint at risk to develop premature osteoarthritis. Several surgical procedures like periacetabular osteotomy for hip dysplasia or hip arthroscopy or safe surgical hip dislocation for femoroacetabular impingement aim at restoring the hip anatomy. However, the success of joint preserving surgical procedures is limited by the amount of pre-existing cartilage damage. Biochemically sensitive MRI techniques like delayed Gadolinium Enhanced MRI of Cartilage (dGEMRIC) might help to monitor the effect of surgical or non-surgical procedures in the effort to halt or even reverse joint damage.

scholarly journals Delayed gadolinium-enhanced magnetic resonance imaging of hip joint cartilage (dGEMRIC): pearls and pitfalls

2011 ◽  
Vol 3 (2) ◽  
pp. 11 ◽  
Author(s):  
Bernd Bittersohl
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Hip Joint ◽  
Cartilage Damage ◽  
Mr Arthrography ◽  
Image Resolution ◽  
Current Status ◽  
Joint Cartilage ◽  
Resonance Imaging ◽  
Joint Preservation

With the increasing advances in hip joint preservation surgery, accurate diagnosis and assessment of femoral head and acetabular cartilage status is becoming increasingly important. Magnetic resonance imaging (MRI) of the hip does present technical difficulties. The fairly thin cartilage lining necessitates high image resolution and high contrast-to-noise ratio (CNR). With MR arthrography (MRA) using intraarticular injected gadolinium, labral tears and cartilage clefts may be better identified through the contrast medium filling into the clefts. However, the ability of MRA to detect varying grades of cartilage damage is fairly limited and early histological and biochemical changes in the beginning of osteoarthritis (OA) cannot be accurately delineated. Traditional MRI thus lacks the ability to analyze the biological status of cartilage degeneration. The technique of delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) is sensitive to the charge density of cartilage contributed by glycosaminoglycans (GAGs), which are lost early in the process of OA. Therefore, the dGEMRIC technique has a potential to detect early cartilage damage that is obviously critical for decision-making regarding time and extent of intervention for joint-preservation. In the last decade, cartilage imaging with dGEMRIC has been established as an accurate and reliable tool for assessment of cartilage status in the knee and hip joint. This review outlines the current status of dGEMRIC for assessment of hip joint cartilage. Practical modifications of the standard technique including three-dimensional (3D) dGEMRIC and dGEMRIC after intra-articular gadolinium instead of iv-dGEMRIC will also be addressed.

scholarly journals Dysplastic Hip Joint Configuration After Bernese Periacetabular Osteotomy

2021 ◽  
Author(s):  
Kamil Kołodziejczyk ◽  
Adam Czwojdziński ◽  
Andrzej Sionek ◽  
Jarosław Czubak
Keyword(s):  
Surgical Treatment ◽  
Femoral Head ◽  
Normal Distribution ◽  
Hip Joint ◽  
Hip Dysplasia ◽  
Periacetabular Osteotomy ◽  
Hip Joints ◽  
Radiological Parameters ◽  
Significant Difference ◽  
Dysplastic Hip

Abstract Background: Residual hip dysplasia is one of the factors contributing to early hip joint osteoarthritis. The main problems caused by residual dysplasia are pain and instability of the hip joint caused by the lack of sufficient bony covering of the femoral head. The aim of this work was to radiologically assess the configuration change of a dysplastic hip joint after surgical treatment using the Bernese periacetabular osteotomy procedure.Methods: We assessed the radiological parameters of patients with hip dysplasia treated by Bernense periacetabular osteotomy by performing a digital antero-posterior pelvis X-ray: central edge angle and femoral head coverage, medialization, distalization and ilio-ischial angle parameters. For normally distributed parameters, we used Student’s t-test; for parameters without a normal distribution, we used the Wilcoxon signed-rank test. Correlations were assessed according to a normal distribution using the Pearson and Spearman method.Results: For all parameters, we observed statistically significant differences in the measurements of dysplastic hip joints before and after the surgery. We also observed a statistically significant difference between the structure of dysplastic hip joints prior to the surgery and healthy hip joints from the control group based on all radiological parameters. The resulting medialization was 2.68 mm, distalization was 3.65 mm, and the ilio-ischial angle was changed by 2.62°. There was also an improvement in the femoral head bony covering: CEA by 17.61° and FHC by 16.46%.Conclusions: Based on all the radiological parameters, we presented the difference between healthy and dysplastic hip joints. Learning the parameter values that are used to describe dysplastic hip joints will allow us to improve the imaging of the condition and will also allow for better planning and proper qualification of patients for surgical treatment of hip joint dysplasia.Trial registration: Consent of the bioethics commission Medical Centre of Postgraduate Education 83/PB/2015 18.11.2015 Warsaw

Delayed gadolinium-enhanced magnetic resonance imaging (dGEMRIC) of hip joint cartilage: better cartilage delineation after intra-articular than intravenous gadolinium injection

2006 ◽  
Vol 47 (4) ◽  
pp. 391-396 ◽  
Author(s):  
M. Boesen ◽  
K. E. Jensen ◽  
E. Qvistgaard ◽  
B. Danneskiold-SamsØe ◽  
C. Thomsen ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Hip Joint ◽  
Sagittal Plane ◽  
Spin Echo ◽  
Cartilage Damage ◽  
Hip Osteoarthritis ◽  
Joint Cartilage ◽  
Resonance Imaging ◽  
Ultrasound Guided

Purpose: To investigate and compare delayed gadolinium (Gd-DTPA)-enhanced magnetic resonance imaging (MRI) of cartilage (dGEMRIC) in the hip joint using intravenous (i.v.) or ultrasound-guided intra-articular (i.a.) Gd-DTPA injection. Material and Methods: In 10 patients (50% males, mean age 58 years) with clinical and radiographic hip osteoarthritis (OA; Kellgren score II–III), MRI of the hip was performed twice on a clinical 1.5T MR scanner: On day 1, before and 90–180 min after 0.3 mmol/kg body weight i.v. Gd-DTPA and, on day 8, 90–180 min after ultrasound-guided i.a. injection of a 4 mmol/l Gd-DTPA solution. Coronal STIR, coronal T1 fat-saturated spin-echo, and a cartilage-sensitive gradient-echo sequence (3D T1 SPGR) in the sagittal plane were applied. Results: Both the post-i.v. and post-i.a. Gd-DTPA images showed significantly higher signal-to-noise (SNR) and contrast-to-noise (CNR) in the joint cartilage compared to the non-enhanced images ( P<0.002). I.a. Gd-DTPA provided significantly higher SNR and CNR compared to i.v. Gd-DTPA ( P<0.01). Furthermore, a better delineation of the cartilage in the synovial/cartilage zone and of the chondral/subchondral border was observed. Conclusion: The dGEMRIC MRI method markedly improved delineation of hip joint cartilage compared to non-enhanced MRI. The i.a. Gd-DTPA provided the best cartilage delineation. dGEMRIC is a clinically applicable MRI method that may improve identification of early subtle cartilage damage and the accuracy of volume measurements of hip joint cartilage.

scholarly journals Complications associated with combined surgical hip dislocation and periacetabular osteotomy for complex hip deformities

2019 ◽  
Vol 6 (2) ◽  
pp. 117-123 ◽  
Author(s):  
Adam I Edelstein ◽  
Stephen T Duncan ◽  
Sean Akers ◽  
Gail Pashos ◽  
Perry L Schoenecker ◽  
...  
Keyword(s):  
Perioperative Complications ◽  
Periacetabular Osteotomy ◽  
Hip Dislocation ◽  
Labral Repair ◽  
Harris Hip Score ◽  
Surgical Hip Dislocation ◽  
Level Of Evidence ◽  
Permanent Disability ◽  
Superior Pubic Ramus

AbstractSurgical hip dislocation (SD) and periacetabular osteotomy (PAO) are well-described treatments for femoroacetabular impingement (FAI) and acetabular dysplasia, respectively. Occasionally, complex deformities require a combined SD/PAO; the morbidity of performing both procedures in a single stage has not been fully investigated. We performed a retrospective review of a consecutive group of patients undergoing combined SD/PAO to investigate the incidence and character of perioperative complications. Forty-five patients (46 hips) were identified. Perioperative complications were graded by the modified Clindo-Davien complication scheme. Mean follow-up was 36 months (range 12–128), and no patients were lost to follow-up. Six complications occurred in six hips (13%). Four (8.7%) complications were minor (Grades I or II): one Brooker Grade III heterotopic ossification requiring no treatment, one superior pubic ramus nonunion requiring no treatment and two superficial wound infections requiring antibiotics. Two (4.3%) complications were major (Grades III or IV): one coxa saltans interna and labral tear requiring hip arthroscopy with labral repair and iliopsoas lengthening, and one deep surgical site infection requiring irrigation and debridement followed by development of arthritis requiring conversion to arthroplasty. The average Harris hip score improved from 62 ± 13 preoperatively to 80 ± 19 at final follow-up. Except for the single joint replacement, there were no long-term disabilities. There were no major neurovascular injuries, osteonecrosis, fractures or trochanteric nonunions. Combined SD/PAO for the treatment of complex, concomitant deformities of the proximal femur and acetabulum is associated with an acceptable risk of complications. The vast majority of complications that occurred were managed without permanent disability.Level of Evidence: IV

scholarly journals Biochemical MRI With dGEMRIC Corresponds to 3D-CT Based Impingement Location for Detection of Acetabular Cartilage Damage in FAI Patients

2021 ◽  
Vol 9 (3) ◽  
pp. 232596712098817
Author(s):  
Till D. Lerch ◽  
Dimitri Ambühl ◽  
Florian Schmaranzer ◽  
Inga A.S. Todorski ◽  
Simon D. Steppacher ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Surgical Treatment ◽  
Magnetic Resonance ◽  
Hip Joint ◽  
Cartilage Damage ◽  
Patient Specific ◽  
3D Ct ◽  
Acetabular Cartilage ◽  
Resonance Imaging ◽  
The Mean

Background: Anterior femoroacetabular impingement (FAI) is associated with labral tears and acetabular cartilage damage in athletic and young patients. Delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) is an imaging method for detecting early damage to cartilage. Purpose: We evaluated the following questions: (1) What is the sensitivity and specificity of morphological magnetic resonance imaging (MRI) and dGEMRIC for detecting cartilage damage? Do the mean acetabular and femoral dGEMRIC indices differ between (2) superior acetabular clock positions with and without impingement and (3) between cam- and pincer-type FAI? Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: This was a retrospective comparative study of 21 hips (20 patients with symptomatic anterior FAI) without osteoarthritis on anteroposterior radiographs. Morphological MRI and dGEMRIC (3.0-T, 3-dimensional [3D] T1 maps, dual–flip angle technique) of the same hip joint were compared. Intraoperative acetabular cartilage damage was assessed in patients who underwent surgical treatment. Computed tomography (CT)–based 3D bone models of the same hip joint were used as the gold standard for the detection of impingement, and dGEMRIC indices and zones of morphologic damage were compared with the CT-based impingement zones. Results: Of the 21 hips, 10 had cam-type FAI and 8 had pincer-type FAI according to radiographs. The mean age was 30 ± 9 years (range, 17-48 years), 71% were female, and surgical treatment was performed in 52%. We found a significantly higher sensitivity (69%) for dGEMRIC compared with morphological MRI (42%) in the detection of cartilage damage ( P < .001). The specificity of dGEMRIC was 83% and accuracy was 78%. The mean peripheral acetabular and femoral dGEMRIC indices for clock positions with impingement (485 ± 141 and 440 ± 121 ms) were significantly lower compared with clock positions without impingement (596 ± 183 and 534 ± 129 ms) ( P < .001). Hips with cam-type FAI had significantly lower acetabular dGEMRIC indices compared with hips with pincer-type FAI on the anterosuperior clock positions (1 to 3 o’clock) ( P = .018). Conclusion: MRI with dGEMRIC was more sensitive than morphological MRI, and lower dGEMRIC values were found for clock positions with impingement as detected on 3D-CT. This could aid in patient-specific diagnosis of FAI, preoperative patient selection, and surgical decision making to identify patients with cartilage damage who are at risk for inferior outcomes after hip arthroscopy.

scholarly journals Methods of diagnosis of hip dysplasia in dogs

2021 ◽  
Vol 37 ◽  
pp. 00043
Author(s):  
Elena Lyubchenko ◽  
Irina Bondarenko ◽  
Tatyana Timofeeva
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Hip Joint ◽  
Hip Dysplasia ◽  
Disease Process ◽  
Test System ◽  
Knee Joints ◽  
X Rays ◽  
Resonance Imaging ◽  
X Ray

To diagnose hip dysplasia, you can use a test system, the essence of which is to create a subhabitation in the hip joint of the dog, laid on the side, while there is a click in the joint, which means that the test is positive, while the pressure on the knee joint of the hip joint does not happen. The most common method of diagnosing dysplasia worldwide is X-ray, in which the age of the dogs studied should be more than a year, and large and giant breeds are studied in the range of one to one and a half years, with the animal laid on the back so that the X-ray image shows the pelvis with the wings of the iliac bone and femurs, including the knee joints, therefore, it is also necessary to use sedation, which allows you to comply with all the requirements for styling. The resulting X-rays are assessed according to the main Xray characteristics of the hip joint, taking measurements on six parameters presented in the text of this article, and determining the type of dysplasia. Computed tomography and magnetic resonance imaging can reveal the instability of the pathology in the hip joint and improve understanding of the disease process.

Hip muscle and joint contact forces before, 6 and 12 months after minimally invasive periacetabular osteotomy

2020 ◽  
pp. 112070002092541
Author(s):  
Henrik Sørensen ◽  
Ole Skalshøi ◽  
Dennis Brandborg Nielsen ◽  
Julie Sandell Jacobsen ◽  
Kjeld Søballe ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Contact Force ◽  
Hip Joint ◽  
Muscle Function ◽  
Hip Dysplasia ◽  
Periacetabular Osteotomy ◽  
Contact Forces ◽  
Joint Contact Force ◽  
Hip Muscle ◽  
Joint Contact

Background: Previous studies on different periacetabular osteotomy approaches for correction of hip dysplasia disagree on the time course of normalisation of muscle function postoperatively, some stating that especially hip flexor function is not fully normalised after 12 months. Purpose: The purpose of this study was to evaluate hip function during walking before, and 6 and 12 months after minimally invasive periacetabular osteotomy. Methods: Using conventional 3D inverse dynamics followed by static optimisation, we calculated hip net joint moment and angular impulse, as well as individual muscle forces and hip joint contact force, during walking for 32 patients with hip dysplasia and 32 matched controls. Results: None of the extensor and abductor measures were significantly different between controls and patients tested preoperatively, nor between any of the 3 time points patients were tested. For all of the flexor measures, patients’ preoperative values were lower than controls’, but had increased to values above the controls 6 months postoperatively. Conclusion: Hip muscle function during walking seemed normalised after 6 months after minimally invasive periacetabular osteotomy, while joint contact force did not fully normalise until 12 months postoperatively, perhaps because the hip joint structures need a longer time to heal than the muscles and a potential pain alleviating strategy was still in effect. Trial registry: Movement pattern in patients with hip dysplasia https://clinicaltrials.gov/ct2/show/NCT01344421 , NCT01344421.

scholarly journals Incidence of Femoroacetabular Impingement and Surgical Management Trends Over Time

2020 ◽  
Vol 49 (1) ◽  
pp. 35-41 ◽  
Author(s):  
Rena F. Hale ◽  
Heath P. Melugin ◽  
Jun Zhou ◽  
Matthew D. LaPrade ◽  
Christopher Bernard ◽  
...  
Keyword(s):  
Physical Examination ◽  
Surgical Management ◽  
Hip Arthroscopy ◽  
Periacetabular Osteotomy ◽  
Hip Dislocation ◽  
Hip Pain ◽  
Surgical Hip Dislocation ◽  
Trends Over Time ◽  
Male Patients ◽  
Over Time

Background: Femoroacetabular impingement (FAI) is a well-known cause of hip pain in adolescents and young adults. However, the incidence in the general population has not been clearly defined. Purpose: To (1) define the population-based incidence of diagnosis of FAI in patients with hip pain, (2) report the trends in diagnosis of FAI over time, and (3) determine the changes in the rate and type of surgical management over time. Study Design: Cohort study; Level of evidence, 3. Methods: A geographic database was used to identify patients who were 14 to 50 years old with hip pain between the years 2000 and 2016. Chart and radiographic review was performed to determine which patients had FAI. To be included, patients had to have a triad of clinical symptoms, physical examination signs, and imaging findings consistent with FAI. Medical records were reviewed to obtain demographic information, clinical history, physical examination findings, imaging details, and treatment details. Statistical analysis determined the overall age- and sex-adjusted annual incidence of FAI diagnosis and trends over time. Results: There were 1893 patients evaluated with hip pain, and 716 (38%; 813 hips) had diagnosed FAI. The mean ± SD age was 27.2 ± 8.4 years, and 67% were female. The incidence of FAI diagnosis was 54.4 per 100,000 person-years. Female patients had a higher incidence than male patients (73.2 vs 36.1 per 100,000 person-years; P < .01). Incidence of FAI diagnosis were higher from 2010 to 2016 (72.6 per 100,000 person-years; P < .01) as compared with 2005 to 2009 (45.3) and 2000 to 2004 (40.3). Hip arthroscopy, surgical hip dislocation, and periacetabular osteotomy utilization increased from the 2000-2004 to 2010-2016 periods, respectively: 1 (1%) to 160 (20%; P = .04), 2 (1%) to 37 (5%; P = .01), and 1 (1%) to 22 (3%; P = .58). Conclusion: The overall incidence of FAI diagnosis was 54.4 per 100,000 person-years, and it consistently increased between 2000 and 2016. Female patients had a higher incidence than male patients. The utilization of joint preservation operations, including hip arthroscopy, surgical hip dislocation, and anteverting periacetabular osteotomy, increased over time.

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