nach oben

Clinical Orthopaedics and Related Research®

Erschienen in:

01.07.2010 | Clinical Research

Cartilage Thickness in the Hip Measured by MRI and Stereology Before and After Periacetabular Osteotomy

verfasst von: Inger Mechlenburg, MSc, PhD, Jens R. Nyengaard, MD, DMSc, John Gelineck, MD, Kjeld Soballe, MD, DMSc, Anders Troelsen, MD, PhD

Erschienen in: Clinical Orthopaedics and Related Research® | Ausgabe 7/2010

Einloggen, um Zugang zu erhalten

Abstract

Background

Untreated hip dysplasia can result in a degenerative process joint and secondary osteoarthritis at an early age. While most periacetabular osteotomies (PAOs) are performed to relieve symptoms, the osteotomy is presumed to slow or prevent degeneration unless irreparable damage to the cartilage has already occurred.

Questions/purposes

We therefore determined (1) whether changes in the thickness of the cartilage in the hip occur after PAO, and (2) how many patients had an acetabular labral tear and whether labral tears are associated with thinning of the cartilage after PAO.

Patients and Methods

We prospectively followed 22 women and four men with hip dysplasia with MRI before PAO and again 1 year and 2½ years postoperatively to determine if cartilage thinning (reflecting osteoarthritis) occurred. The thickness of the femoral and acetabular cartilage was estimated with a stereologic method. Three and one-half years postoperatively, 18 of 26 patients underwent MR arthrography to investigate if they had a torn acetabular labrum.

Results

The acetabular cartilage thickness differed between 1 and 2½ years postoperatively (preoperative 1.40 mm, 1 year postoperatively 1.47 mm, and 2½ years postoperatively 1.35 mm), but was similar at all times for the femoral cartilage (preoperative 1.38 mm, 1 year postoperatively 1.43 mm, and 2½ years postoperatively 1.38 mm.) Seventeen of 18 patients had a torn labrum. The tears were located mainly superior on the acetabular rim.

Conclusion

Cartilage thickness 2½ years after surgery compared with preoperatively was unchanged indicating the osteoarthritis had not progressed during short-term followup after PAO.

Armand M, Lepisto J, Tallroth K, Elias J, Chao E. Outcome of periacetabular osteotomy: joint contact pressure calculation using standing AP radiographs, 12 patients followed for average 2 years. Acta Orthop. 2005;76:303–313.PubMed

Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1:307–310.PubMed

Calvo E, Palacios I, Delgado E, Sánchez-Pernaute O, Largo R, Egido J, Herrero-Beaumont G. Histopathological correlation of cartilage swelling detected by magnetic resonance imaging in early experimental osteoarthritis. Osteoarthritis Cartilage. 2004;12:878–886.CrossRefPubMed

Chan YS, Lien LC, Hsu HL, Wan YL, Lee MS, Hsu KY, Shih CH. Evaluating hip labral tears using magnetic resonance arthrography: a prospective study comparing hip arthroscopy and magnetic resonance arthrography diagnosis. Arthroscopy. 2005;21:1250.CrossRefPubMed

Cooperman DR, Wallensten R, Stulberg SD. Acetabular dysplasia in the adult. Clin Orthop Relat Res. 1983;175:79–85.PubMed

Freedman BA, Potter BK, Dinauer PA, Giuliani JR, Kuklo TR, Murphy KP. Prognostic value of magnetic resonance arthrography for Czerny stage II and III acetabular labral tears. Arthroscopy. 2006;22:742–747.CrossRefPubMed

Fujii M, Nakashima Y, Jingushi S, Yamamoto T, Noguchi Y, Suenaga E, Iwamoto Y. Intraarticular findings in symptomatic developmental dysplasia of the hip. J Pediatr Orthop. 2009;29:9–13.PubMed

Goldring MB, Marcu KB. Cartilage homeostasis in health and rheumatic diseases. Arthritis Res Ther. 2009;11:224.CrossRefPubMed

Goldring MB, Otero M, Tsuchimochi K, Ijiri K, Li Y. Defining the roles of inflammatory and anabolic cytokines in cartilage metabolism. Ann Rheum Dis. 2008;67(suppl 3):iii75–iii82.CrossRefPubMed

10.

Guevara CJ, Pietrobon R, Carothers JT, Olson SA, Vail TP. Comprehensive morphologic evaluation of the hip in patients with symptomatic labral tear. Clin Orthop Relat Res. 2006;453:277–285.CrossRefPubMed

11.

Hipp JA, Sugano N, Millis MB, Murphy SB. Planning acetabular redirection osteotomies based on joint contact pressures. Clin Orthop Relat Res. 1999;364:134–143.CrossRefPubMed

12.

Jacobsen S. Adult hip dysplasia and osteoarthritis: studies in radiology and clinical epidemiology. Acta Orthop Suppl. 2006;77:1–37.CrossRefPubMed

13.

Klaue K, Durnin CW, Ganz R. The acetabular rim syndrome: a clinical presentation of dysplasia of the hip. J Bone Joint Surg Br. 1991;73:423–429.PubMed

14.

Kralj M, Mavcic B, Antolic V, Iglic A, Kralj-Iglic V. The Bernese periacetabular osteotomy: clinical, radiographic and mechanical 7–15-year follow-up of 26 hips. Acta Orthop. 2005;76:833–840.CrossRefPubMed

15.

Leunig M, Podeszwa D, Beck M, Werlen S, Ganz R. Magnetic resonance arthrography of labral disorders in hips with dysplasia and impingement. Clin Orthop Relat Res. 2004;418:74–80.CrossRefPubMed

16.

Llopis E, Cerezal L, Kassarjian A, Higueras V, Fernandez E. Direct MR arthrography of the hip with leg traction: feasibility for assessing articular cartilage. AJR Am J Roentgenol. 2008;190:1124–1128.CrossRefPubMed

17.

MacDonald SJ, Hersche O, Ganz R. Periacetabular osteotomy in the treatment of neurogenic acetabular dysplasia. J Bone Joint Surg Br. 1999;81:975–978.CrossRefPubMed

18.

Matta JM, Stover MD, Siebenrock K. Periacetabular osteotomy through the Smith-Petersen approach. Clin Orthop Relat Res. 1999;363:21–32.PubMed

19.

McCarthy JC, Noble PC, Schuck MR, Wright J, Lee J. The Otto E. Aufranc Award: The role of labral lesions to development of early degenerative hip disease. Clin Orthop Relat Res. 2001;393:25–37.CrossRefPubMed

20.

McCarthy JC, Noble PC, Schuck MR, Wright J, Lee J. The watershed labral lesion: its relationship to early arthritis of the hip. J Arthroplasty. 2001;16:81–87.CrossRefPubMed

21.

Mechlenburg I. Evaluation of Bernese periacetabular osteotomy: prospective studies examining projected load-bearing area, bone density, cartilage thickness and migration. Acta Orthop Suppl. 2008;79:4–43.PubMed

22.

Mechlenburg I, Nyengaard JR, Gelineck J, Soballe K. Cartilage thickness in the hip joint measured by MRI and stereology: a methodological study. Osteoarthritis Cartilage. 2007;15:366–371.CrossRefPubMed

23.

Mechlenburg I, Nyengaard JR, Romer L, Soballe K. Changes in load-bearing area after Ganz periacetabular osteotomy evaluated by multislice CT scanning and stereology. Acta Orthop Scand. 2004;75:147–153.CrossRefPubMed

24.

Michaeli DA, Murphy SB, Hipp JA. Comparison of predicted and measured contact pressures in normal and dysplastic hips. Med Eng Phys. 1997;19:180–186.CrossRefPubMed

25.

Murphy S, Deshmukh R. Periacetabular osteotomy: preoperative radiographic predictors of outcome. Clin Orthop Relat Res. 2002;405:168–174.CrossRefPubMed

26.

Murphy SB, Ganz R, Muller ME. The prognosis in untreated dysplasia of the hip: a study of radiographic factors that predict the outcome. J Bone Joint Surg Am. 1995;77:985–989.PubMed

27.

Nakamura S, Yorikawa J, Otsuka K, Takeshita K, Harasawa A, Matsushita T. Evaluation of acetabular dysplasia using a top view of the hip on three-dimensional CT. J Orthop Sci. 2000;5:533–539.CrossRefPubMed

28.

Nakanishi K, Tanaka H, Nishii T, Masuhara K, Narumi Y, Nakamura H. MR evaluation of the articular cartilage of the femoral head during traction: correlation with resected femoral head. Acta Radiol. 1999;40:60–63.PubMed

29.

Neumann G, Mendicuti AD, Zou KH, Minas T, Coblyn J, Winalski CS, Lang P. Prevalence of labral tears and cartilage loss in patients with mechanical symptoms of the hip: evaluation using MR arthrography. Osteoarthritis Cartilage. 2007;15:909–917.CrossRefPubMed

30.

Nishii T, Nakanishi K, Sugano N, Masuhara K, Ohzono K, Ochi T. Articular cartilage evaluation in osteoarthritis of the hip with MR imaging under continuous leg traction. Magn Reson Imaging. 1998;16:871–875.CrossRefPubMed

31.

Nishii T, Nakanishi K, Sugano N, Naito H, Tamura S, Ochi T. Acetabular labral tears: contrast-enhanced MR imaging under continuous leg traction. Skeletal Radiol. 1996;25:349–356.CrossRefPubMed

32.

Nishii T, Tanaka H, Sugano N, Miki H, Takao M, Yoshikawa H. Disorders of acetabular labrum and articular cartilage in hip dysplasia: evaluation using isotropic high-resolutional CT arthrography with sequential radial reformation. Osteoarthritis Cartilage. 2007;15:251–257.CrossRefPubMed

33.

Nyengaard JR. Stereologic methods and their application in kidney research. J Am Soc Nephrol. 1999;10:1100–1123.PubMed

34.

Peters CL, Erickson JA, Hines JL. Early results of the Bernese periacetabular osteotomy: the learning curve at an academic medical center. J Bone Joint Surg Am. 2006;88:1920–1926.CrossRefPubMed

35.

Pogliacomi F, Stark A, Wallensten R. Periacetabular osteotomy: good pain relief in symptomatic hip dysplasia, 32 patients followed for 4 years. Acta Orthop. 2005;76:67–74.CrossRefPubMed

36.

Schnier M, Eckstein F, Priebsch J, Haubner M, Sittek H, Becker C, Putz R, Englmeier KH, Reiser M. [Three-dimensional thickness and volume measurements of the knee joint cartilage using MRI: validation in an anatomical specimen by CT arthrography] [in German]. Rofo. 1997;167:521–526.PubMed

37.

Siebenrock KA, Scholl E, Lottenbach M, Ganz R. Bernese periacetabular osteotomy. Clin Orthop Relat Res. 1999;363:9–20.CrossRefPubMed

38.

Steppacher SD, Tannast M, Ganz R, Siebenrock KA. Mean 20-year followup of Bernese periacetabular osteotomy. Clin Orthop Relat Res. 2008;466:1633–1644.CrossRefPubMed

39.

Tönnis D. Congenital Dysplasia and Dislocation of the Hip in Children and Adults. Berlin, Germany: Springer; 1987.

40.

Troelsen A, Elmengaard B, Soballe K. A new minimally invasive transsartorial approach for periacetabular osteotomy. J Bone Joint Surg Am. 2008;90:493–498.CrossRefPubMed

41.

Troelsen A, Jacobsen S, Bolvig L, Gelineck J, Rømer L, Søballe K. Ultrasound versus magnetic resonance arthrography in acetabular labral tear diagnostics: a prospective comparison in 20 dysplastic hips. Acta Radiol. 2007;48:1004–1010.CrossRefPubMed

42.

Trousdale RT, Ekkernkamp A, Ganz R, Wallrichs SL. Periacetabular and intertrochanteric osteotomy for the treatment of osteoarthrosis in dysplastic hips. J Bone Joint Surg Am. 1995;77:73–85.PubMed

43.

Valenzuela RG, Cabanela ME, Trousdale RT. Sexual activity, pregnancy, and childbirth after periacetabular osteotomy. Clin Orthop Relat Res. 2004;418:146–152.CrossRefPubMed

44.

van Bergayk AB, Garbuz DS. Quality of life and sports-specific outcomes after Bernese periacetabular osteotomy. J Bone Joint Surg Br. 2002;84:339–343.CrossRefPubMed

45.

Wenger DR, Bomar JD. Human hip dysplasia: evolution of current treatment concepts. J Orthop Sci. 2003;8:264–271.CrossRefPubMed

46.

Wiberg G. Studies on dysplastic acetabula and congenital subluxation of the hip joint. Acta Orthop Scand Suppl. 1939;58:1–132.

47.

Yanagimoto S, Hotta H, Izumida R, Sakamaki T. Long-term results of Chiari pelvic osteotomy in patients with developmental dysplasia of the hip: indications for Chiari pelvic osteotomy according to disease stage and femoral head shape. J Orthop Sci. 2005;10:557–563.CrossRefPubMed

Titel: Cartilage Thickness in the Hip Measured by MRI and Stereology Before and After Periacetabular Osteotomy
verfasst von: Inger Mechlenburg, MSc, PhD
Jens R. Nyengaard, MD, DMSc
John Gelineck, MD
Kjeld Soballe, MD, DMSc
Anders Troelsen, MD, PhD
Publikationsdatum: 01.07.2010
Verlag: Springer-Verlag
Erschienen in: Clinical Orthopaedics and Related Research® / Ausgabe 7/2010
Print ISSN: 0009-921X
Elektronische ISSN: 1528-1132
DOI: https://doi.org/10.1007/s11999-010-1310-z

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Die Highlights vom Kongress des American College of Cardiology 2024

Springer Medizin

Cartilage Thickness in the Hip Measured by MRI and Stereology Before and After Periacetabular Osteotomy