Association of cartilage defects, and other MRI findings with pain and function in individuals with mild-moderate radiographic hip osteoarthritis and controls

Abstract

Objective: To evaluate the relationship of hip radiographic osteoarthritis (ROA) and MRI findings of cartilage lesions, labral tears, bone marrow edema-like lesions (BMELs) and subchondral cysts with self-reported and physical function.

Design: Eighty five subjects were classified as controls (n = 55, Kellgren-Lawrence (KL) 0, 1) or having mild-moderate ROA (n = 30, KL 2, 3). T2 weighted MRI images at 3-T were graded for presence of cartilage lesions, labral tears, BMELs and subchondral cysts. Posterior wall sign, cross-over sign, center-edge angle and alpha angle were also recorded. Function was assessed using Hip dysfunction and Osteoarthritis Outcome Score (HOOS), Timed-Up and Go (TUG) test and Y-Balance Test (YBT). Analysis compared function between subjects with and without ROA and those with and without femoral or acetabular cartilage lesions, adjusted for age. Non-parametric correlations were used to assess the relationship between radiographic scores, MRI scores and function.

Results: Subjects with acetabular cartilage lesions had worse HOOS (Difference = 5-10%, P = 0.036-0.004), but not TUG or YBT, scores. Acetabular cartilage lesions, BMELs and subchondral cysts were associated with worse HOOS scores (ρ = 0.23-0.37, P = 0.041-0.001). Differences in function between subjects with and without ROA or femoral cartilage lesions were not significant. Other radiologic findings were not associated with function.

Conclusions: Acetabular cartilage defects, but not femoral cartilage defects or ROA, were associated with greater self-reported pain and disability. BMELs and subchondral cysts were related to greater hip related self-reported pain and disability. None of the radiographic or MRI features was related to physical function.

Keywords: BMEL; Balance; Kellgren–Lawrence; Labral tears; Subchondral cyst; Y-Balance Test.

Figure 1

Subregions of articular cartilage. for femur on coronal (a) and sagittal (c) images. Subregions for acetabulum on coronal (b) and sagittal (d) images. (a) coronal MR image demonstrating acetabular superolateral (ASL) and superomedial (ASM) subregions divided by vertical line extending from femoral head center.(b) coronal MR image demonstrating femoral lateral (FL), superolateral (FSL) and superomedial (FSM) and inferior (FIM) subregions divided by line extending from femoral head center, to the lateral acetabular rim, to straight vertical direction and to the ligamentum teres attachment. (c) sagittal MR image demonstrates acetabular anterior (AA) and posterior (AP) subregion, demarcated by vertical line 1 cm from the most anterior and posterior aspect of the femoral head. (d) sagittal MR image demonstrates femoral anterior (FA) and posterior (FP) subregion, demarcated by vertical line 1 cm from the most anterior and posterior aspect of the femoral head.