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.

Autor:	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
Předmět:	FEMORACETABULAR impingement PATIENT aftercare DEEP learning JOINT radiography CONVALESCENCE STRUCTURAL models OPERATIVE surgery PHYSICAL therapy MAGNETIC resonance imaging FISHER exact test DIAGNOSTIC imaging COMPARATIVE studies SOFTWARE architecture T-test (Statistics) REPEATED measures design RESEARCH funding ARTICULAR cartilage BIOMECHANICS DATA analysis software LONGITUDINAL method
Zdroj:	American Journal of Sports Medicine; Jun2023, Vol. 51 Issue 7, p1808-1817, 10p
Abstrakt:	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. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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