Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Sep 2;10(9):23259671221117606.
doi: 10.1177/23259671221117606. eCollection 2022 Sep.

Correlation of Delayed Gadolinium-Enhanced MRI of Cartilage (dGEMRIC) Value With Hip Arthroscopy Intraoperative Findings and Midterm Periacetabular Osteotomy Outcomes

Jessica H Lee  1 , Darby A Houck  1 , Brandt A Gruizinga  1 , Tigran Garabekyan  2 , Mary K Jesse  3 , Matthew J Kraeutler  4 , Omer Mei-Dan  1
Affiliations

Correlation of Delayed Gadolinium-Enhanced MRI of Cartilage (dGEMRIC) Value With Hip Arthroscopy Intraoperative Findings and Midterm Periacetabular Osteotomy Outcomes

Jessica H Lee et al. Orthop J Sports Med. .

Abstract

Background: Delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) is an advanced imaging technique that is purported to quantify cartilage damage in acute and chronic joint disease and predict periacetabular osteotomy (PAO) outcomes. There is a paucity of literature relating dGEMRIC values to arthroscopic findings before PAO and postoperative outcomes after PAO.

Purpose: To assess the utility and validity of dGEMRIC as a preoperative and prognostic assessment tool of cartilage status and integrity as it relates to intraoperative findings and midterm postoperative outcomes after PAO.

Study design: Case series; Level of evidence, 4.

Methods: We analyzed a cohort of 58 patients (70 hips) with a median age of 30.1 years (range, 15-50) with hip dysplasia who underwent hip arthroscopy, followed by a PAO with preoperative dGEMRIC. The primary outcome measures were intraoperative assessment and correlation with cartilage damage (presence of cartilage flap, Outerbridge grade of the acetabulum and femoral head). Secondary outcome measures were postoperative patient-reported outcome (PRO) scores, including the International Hip Outcome Tool and Non-arthritic Hip Score. Correlation analyses were performed to determine the relationship between dGEMRIC values and (1) PROs and (2) intraoperative assessment of cartilage damage.

Results: There were significant negative linear relationships between dGEMRIC values and the primary outcome measures: presence of a cartilage flap (coronal, P = .004; sagittal, P < .001), Outerbridge grade of acetabular articular cartilage lesion (coronal, P = .002; sagittal, P = .003), and Outerbridge grade of femoral head articular cartilage lesion (coronal, P = .001; sagittal, P < .001). Despite significant overall improvement in all patients, there was no significant correlation between preoperative dGEMRIC values and improvement in PROs from presurgery to latest postoperative follow-up (median, 2.2 years; range, 1.0-5.0 years).

Conclusion: Although dGEMRIC values (sagittal and coronal) were significant predictors of the intraoperative presence of cartilage flaps and overall cartilage integrity, they were not associated with midterm outcomes after PAO.

Keywords: CU PAO; cartilage degeneration; dGEMRIC; hip dysplasia; osteoarthritis.

PubMed Disclaimer

Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: T.G. has received consulting fees from Stryker. M.K.J. has received consulting fees and speaking fees from Medtronic USA and hospitality payments from Medicrea USA. O.M.-D. has received consulting fees from Stryker. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

Figures

Figure 1.
Figure 1.
The bulk dGEMRIC values were the mean of 3 consecutive images obtained from the following regions of interest: (A) the weightbearing articular cartilage in the anterior, middle, and posterior coronal views (outlined in yellow) and (B) the anterolateral quadrant in the medial, central, and lateral sagittal views (outlined in yellow). All images were obtained from a patient who exhibited a cartilage flap intraoperatively. dGEMRIC, delayed gadolinium-enhanced magnetic resonance imaging of cartilage.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

  • The Role of MRI in Groin Pain Syndrome in Athletes.
    Bisciotti GN, Di Pietto F, Rusconi G, Bisciotti A, Auci A, Zappia M, Romano S. Bisciotti GN, et al. Diagnostics (Basel). 2024 Apr 14;14(8):814. doi: 10.3390/diagnostics14080814. Diagnostics (Basel). 2024. PMID: 38667460 Free PMC article. Review.
  • A framework of biomarkers for skeletal aging: a consensus statement by the Aging Biomarker Consortium.
    Aging Biomarker Consortium; Suo J, Gan Y, Xie Y, Xu S, Wang J, Chen D, Chen L, Deng L, Feng S, Han JJ, Jiang Q, Lei G, Liu P, Luo X, Ma X, Qu J, Song C, Tang P, Tang T, Wang S, Wei X, Wu C, Xiao G, Yang L, Zhang L, Zhang W, Zhang Z, Liu GH, Zhang C, Pei G, Luo J, Yue R, Zou W. Aging Biomarker Consortium, et al. Life Med. 2023 Nov 22;2(6):lnad045. doi: 10.1093/lifemedi/lnad045. eCollection 2023 Dec. Life Med. 2023. PMID: 39872060 Free PMC article.
  • What the papers say.
    Bajwa A. Bajwa A. J Hip Preserv Surg. 2023 Feb 16;9(4):277-279. doi: 10.1093/jhps/hnac056. eCollection 2022 Dec. J Hip Preserv Surg. 2023. PMID: 36908553 Free PMC article. No abstract available.

References

    1. Ashwell ZR, Flug J, Chadayammuri V, Pascual-Garrido C, Garabekyan T, Mei-Dan O. Lateral acetabular coverage as a predictor of femoroacetabular cartilage thickness. J Hip Preserv Surg. 2016;3(4):262–269. - PMC - PubMed
    1. Bashir A, Gray ML, Boutin RD, Burstein D. Glycosaminoglycan in articular cartilage: in vivo assessment with delayed Gd(DTPA)(2-)-enhanced MR imaging. Radiology. 1997;205(2):551–558. - PubMed
    1. Bashir A, Gray ML, Burstein D. Gd-DTPA2- as a measure of cartilage degradation. Magn Reson Med. 1996;36(5):665–673. - PubMed
    1. Bashir A, Gray ML, Hartke J, Burstein D. Nondestructive imaging of human cartilage glycosaminoglycan concentration by MRI. Magn Reson Med. 1999;41(5):857–865. - PubMed
    1. Beaulé P, Melkus G, Rakhra K, Wilkin G. Quantitative hip cartilage MRI of patients with hip dysplasia: evaluation of dGEMRIC, T1ρ and T2 mapping. Orthop Proc. 2020;102B:25.

LinkOut - more resources