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  1. Article ; Online: 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.

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

    The American journal of sports medicine

    2023  Volume 51, Issue 7, Page(s) 1808–1817

    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 ... ...

    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
    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.
    MeSH term(s) Humans ; Femoracetabular Impingement/diagnostic imaging ; Femoracetabular Impingement/surgery ; Femoracetabular Impingement/pathology ; Prospective Studies ; Hip Joint/surgery ; Gadolinium ; Cohort Studies ; Longitudinal Studies ; Follow-Up Studies ; Contrast Media ; Cartilage, Articular/diagnostic imaging ; Cartilage, Articular/surgery ; Cartilage, Articular/pathology ; Magnetic Resonance Imaging/methods
    Chemical Substances Gadolinium (AU0V1LM3JT) ; Contrast Media
    Language English
    Publishing date 2023-05-15
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 197482-8
    ISSN 1552-3365 ; 0363-5465
    ISSN (online) 1552-3365
    ISSN 0363-5465
    DOI 10.1177/03635465231167854
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: One-third of Hips After Periacetabular Osteotomy Survive 30 Years With Good Clinical Results, No Progression of Arthritis, or Conversion to THA.

    Lerch, Till Dominic / Steppacher, Simon Damian / Liechti, Emanuel Francis / Tannast, Moritz / Siebenrock, Klaus Arno

    Clinical orthopaedics and related research

    2017  Volume 475, Issue 4, Page(s) 1154–1168

    Abstract: Background: Since its first description in 1984, periacetabular osteotomy (PAO) has become an accepted treatment for hip dysplasia. The 30-year survivorship with this procedure has not been reported. Because these patients are often very young at the ... ...

    Abstract Background: Since its first description in 1984, periacetabular osteotomy (PAO) has become an accepted treatment for hip dysplasia. The 30-year survivorship with this procedure has not been reported. Because these patients are often very young at the time of surgery, long-term followup and identification of factors associated with poor outcome could help to improve patient selection.
    Questions/purposes: Looking at the initial group of patients with hip dysplasia undergoing PAO at the originator's institution, we asked: (1) What is the cumulative 30-year survival rate free from conversion to THA, radiographic progression of osteoarthritis, and/or a Merle d'Aubigné-Postel score < 15? (2) Did hip function improve and pain decrease? (3) Did radiographic osteoarthritis progress? (4) What are the factors associated with one or more of the three endpoints: THA, radiographic progression of osteoarthritis, and/or Merle d'Aubigné-Postel score < 15?
    Methods: We retrospectively evaluated the first 63 patients (75 hips) who underwent PAO for hip dysplasia between 1984 and 1987. At that time, hip dysplasia was the only indication for PAO and no patients with acetabular retroversion, the second indication for a PAO performed today, were included. During that period, no other surgical treatment for hip dysplasia in patients with closed triradiate cartilage was performed. Advanced osteoarthritis (≥ Grade 2 according to Tönnis) was present preoperatively in 18 hips (24%) and 22 patients (23 hips [31%]) had previous femoral and/or acetabular surgery. Thirty-nine patients (42 hips [56%]) were converted to a THA and one patient (one hip [1%]) had hip fusion at latest followup. Two patients (three hips [4%]) died from a cause unrelated to surgery 6 and 16 years after surgery with an uneventful followup. From the remaining 21 patients (29 hips), the mean followup was 29 years (range, 27-32 years). Of those, five patients (six hips [8%]) did not return for the most recent followup and only a questionnaire was available. The cumulative survivorship of the hip according to Kaplan-Meier was calculated if any of the three endpoints, including conversion to THA, progression of osteoarthritis by at least one grade according to Tönnis, and/or a Merle d'Aubigné-Postel score < 15, occurred. Hip pain and function were assessed with Merle d'Aubigné-Postel score, Harris hip score, limp, and anterior and posterior impingement tests. Progression of radiographic osteoarthritis was assessed with Tönnis grades. A Cox regression model was used to calculate factors associated with the previously defined endpoints.
    Results: The cumulative survivorship free from conversion to THA, radiographic progression of osteoarthritis, and/or Merle d'Aubigné-Postel score < 15 was 29% (95% confidence interval, 17%-42%) at 30 years. No improvement was found for either the Merle d'Aubigné-Postel (15 ± 2 versus 16 ± 2, p = 0.144) or Harris hip score (83 ± 11 versus 85 ± 17, p = 0.602). The percentage of a positive anterior impingement test (39% versus 14%, p = 0.005) decreased at 30-year followup, whereas the percentage of a positive posterior impingement test (14% versus 3%, p = 0.592) did not decrease. The percentage of positive limp decreased from preoperatively 66% to 18% at 30-year followup (p < 0.001). Mean osteoarthritis grade (Tönnis) increased from preoperatively 0.8 ± 1 (0-3) to 2.1 ± 1 (0-3) at 30-year followup (p < 0.001). Ten factors associated with poor outcome defined as THA, radiographic progression of osteoarthritis, and/or Merle d'Aubigné-Postel score < 15 were found: preoperative age > 40 years (hazard ratio [HR] 4.3 [3.7-4.9]), a preoperative Merle d'Aubigné-Postel score < 15 (HR 4.1 [3.5-4.6]), a preoperative Harris hip score < 70 (HR 5.8 [5.2-6.4]), preoperative limp (HR 1.7 [1.4-1.9]), presence of a preoperative positive anterior impingement test (HR 3.6 [3.1-4.2]), presence of a preoperative positive posterior impingement test (HR 2.5 [1.7-3.2]), a preoperative internal rotation of < 20° (HR 4.3 [3.7-4.9]), a preoperative Tönnis Grade > 1 (HR 5.7 [5.0-6.4]), a postoperative anterior coverage > 27% (HR 3.2 [2.5-3.9]), and a postoperative acetabular retroversion (HR 4.8 [3.4-6.3]).
    Conclusions: Thirty years postoperatively, 29% of hips undergoing PAO for hip dysplasia can be preserved, but more than 70% will develop progressive osteoarthritis, pain, and/or undergo THA. Periacetabular osteotomy is an effective technique to treat symptomatic hip dysplasia in selected and young patients with closed triradiate cartilage. Hips with advanced joint degeneration (osteoarthritis Tönnis Grade ≥ 2) should not be treated with PAO. Postoperative anterior acetabular overcoverage or postoperative acetabular retroversion were associated with decreased joint survival.
    Level of evidence: Level III, therapeutic study.
    MeSH term(s) Acetabulum/abnormalities ; Acetabulum/diagnostic imaging ; Acetabulum/physiopathology ; Acetabulum/surgery ; Adolescent ; Adult ; Arthroplasty, Replacement, Hip ; Biomechanical Phenomena ; Disability Evaluation ; Disease Progression ; Female ; Hip Dislocation, Congenital/complications ; Hip Dislocation, Congenital/diagnostic imaging ; Hip Dislocation, Congenital/physiopathology ; Hip Dislocation, Congenital/surgery ; Hip Joint/abnormalities ; Hip Joint/diagnostic imaging ; Hip Joint/physiopathology ; Hip Joint/surgery ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Osteoarthritis, Hip/diagnostic imaging ; Osteoarthritis, Hip/etiology ; Osteoarthritis, Hip/physiopathology ; Osteoarthritis, Hip/surgery ; Osteotomy/adverse effects ; Osteotomy/methods ; Proportional Hazards Models ; Range of Motion, Articular ; Recovery of Function ; Reoperation ; Retrospective Studies ; Risk Factors ; Time Factors ; Treatment Outcome ; Young Adult
    Language English
    Publishing date 2017-04
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80301-7
    ISSN 1528-1132 ; 0009-921X
    ISSN (online) 1528-1132
    ISSN 0009-921X
    DOI 10.1007/s11999-016-5169-5
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Uk I Zs.188: Show issues Location:
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    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
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