TITLE

Acetabular Cartilage Delamination in Femoroacetabular Impingement Risk Factors and Magnetic Resonance Imaging Diagnosis

AUTHOR(S)
Anderson, Lucas A.; Peters, Christopher L.; Park, Brandon B.; Stoddard, Gregory J.; Erickson, Jill A.; Crim, Julia R.
PUB. DATE
February 2009
SOURCE
Journal of Bone & Joint Surgery, American Volume;Feb2009, Vol. 91-A Issue 2, p305
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Delamination of acetabular articular cartilage is a common abnormality in hips with femoroacetabular impingement. The purpose of the present study was to identity clinical and radiographic factors predisposing to delamination and to assess the diagnostic accuracy of magnetic resonance arthrography for the detection of these lesions. Methods: Following a retrospective review of records, we determined that acetabular cartilage delamination had been present in twenty-eight of sixty-four hips that had undergone a surgical dislocation procedure for the treatment of femoroacetabular impingement. Multivariable logistic regression was performed to assess the correlation of radiographic findings (i.e., magnetic resonance imaging and computerized tomography findings) with the status of delamination. The preoperative interpretations of the magnetic resonance arthrograms for twenty-seven hips that underwent surgical dislocation were reviewed to assess the accuracy of detecting delamination. At the time of surgery, nine of these twenty- seven hips were found to have delamination. Magnetic resonance arthrography interpretations that did not correlate with operative findings were subjected to conspicuity assessment and error analysis. Results: The rate of delamination of the acetabular cartilage as noted at the time of surgical dislocation was 44% (twenty-eight of sixty-four). Delamination was strongly associated with male sex and femoral sided signs of impingement; however, it was not associated with acetabular overcoverage (center-edge angle, >40°) (odds ratio = 0.16; p < 0.05). While there was no significant difference in the prevalence of labral lesions between groups, whenever labral and delamination lesions were found in the same hip, they were directly adjacent to one another. Preoperative magnetic resonance arthrography had a low sensitivity for delamination (22%) but had a high specificity (100%). Two-thirds of the delamination lesions were visible on retrospective review of these images when the reader was unblinded to the surgical findings. Delamination could most often be identified on the sagittal Ti-weighted image and on the proton-density sequences with fat saturation. Discussion: There should be a high level of suspicion for articular cartilage delamination in men and in patients with primarily cam-type femoroacetabular impingement. Acetabular overcoverage may be protective against delamination. Preoperative high-quality magnetic resonance arthrograms should be carefully analyzed for evidence of delamination in this patient population. Level of Evidence: Diagnostic Level III. See Instructions to Authors for a complete description of levels of evidence.
ACCESSION #
36627710

 

Related Articles

  • Shoulder function, performance depend on its cartilage. Aronen, John // Handball;Feb2009, Vol. 59 Issue 1, p64 

    The article deals with the health of articular cartilage of the shoulder. It discusses the function of cartilage in the bone, as well as the function of synovial fluids to the joints and articular cartilage. It describes the two types of synovial cells and the cause of their inflammation. It...

  • Articular cartilage: structure, injuries and review of management. Abhijit M. Bhosale; James B. Richardson // British Medical Bulletin;Sep2008, Vol. 87 Issue 1, p77 

    : Introduction Chondral and osteochondral injuries are commonly seen in todays clinical practice. Articular cartilage provides an ultimate low-friction gliding surface, which none of the artificial constructs have been able to replace successfully. Retrospective review of the knee arthroscopies...

  • High resolution MRI imaging at 9.4 Tesla of the osteochondral unit in a translational model of articular cartilage repair. Goebel, Lars; Müller, Andreas; Bücker, Arno; Madry, Henning // BMC Musculoskeletal Disorders;2015, Vol. 16 Issue 1, p1 

    Background: Non-destructive structural evaluation of the osteochondral unit is challenging. Here, the capability of high-field magnetic resonance imaging (µMRI) at 9.4 Tesla (T) was explored to examine osteochondral repair ex vivo in a preclinical large animal model. A specific aim of this...

  • Therapie von Gelenkknorpelschäden. D. Albrecht; K. Weise // Der Chirurg;Oct2008, Vol. 79 Issue 10, p989 

    Zusammenfassung  Gelenkknorpelschäden des Erwachsenen besitzen keine Regenerationsfähigkeit. Unbehandelte Knorpeldefekte münden nach unterschiedlicher Latenzzeit in eine Arthrose, so dass eine zeitnahe Defektsanierung notwendig ist. Zur Behandlung lokaler Knorpeldefekte stehen...

  • Golimumab. Oldfield, Vicki; Plosker, Greg L. // BioDrugs;2009, Vol. 23 Issue 2, p125 

    Golimumab is a human anti-tumor necrosis factor (TNF) monoclonal antibody that acts principally by targeting and neutralizing TNF to prevent intlammation and destruction of cartilage and bone. Large, randomized, double-blind trials in patients with rheumatoid arthritis who were...

  • Abstracts of recent literature. Edelstein, Joan E.; Schein, Jerome D. // Journal of Rehabilitation Research & Development;Summer91, Vol. 28 Issue 3, p87 

    Presents an abstract of the article `Exercise and Gait Effects on In Vivo Hip Contact Pressures,' by D.E. Krebs, L. Elbaum et al published in the `Physical Therapy' periodical.

  • PO-SI-048-S.  // Physical Therapy;May1997, Vol. 77 Issue 5, pS17 

    Presents an abstract of a paper entitled `A Functional Outcome Case Study Utilizing Iontophoresis Versus Ultrasound in Piriformis Syndrome,' by B. Coon and A. Hart, presented at the Physical Therapy `97: Scientific Meeting and Exposition of the American Physical Therapy Association.

  • Periacetabular Osteotomy Through a Modified Ollier Transtrochanteric Approach for Treatment of Painful Dyspl astic Hips. Jih-Yang Ko; Ching-Jen Wang; Chien-Fu Jeff Lin; Chun-Hsiung Shih // Journal of Bone & Joint Surgery, American Volume;Sep2002, Vol. 84-A Issue 9, p1594 

    Background: Elimination of abnormally high joint-loading resulting in excessive contact stresses may prevent or reduce the onset of osteoarthrosis in a dysplastic hip. A number of periacetabular osteotomies have been shown to be effective in restoring normal hip-joint mechanics. We treat...

  • MRI Sooner than Later for Ankle Assessment. Wright, Tamara; Langer, Paul // Running & FitNews;Sep/Oct2008, Vol. 26 Issue 5, p17 

    The article provides an answer to a question about a cartilage damage.

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics