Preoperative Delayed Gadolinium-Enhanced Magnetic Resonance Imaging of Cartilage (dGEMRIC) for Patients Undergoing Hip Arthroscopy: Indices Are Predictive of Magnitude of Improvement in Two-Year Patient-Reported Outcomes
Authors
Chandrasekaran S, Vemula SP, Lindner D, Lodhia P, Suarez-Ahedo C, Domb BG.
DOI: 10.2106/JBJS.N.01253
Purpose
To determine whether preoperative dGEMRIC indices predict two-year patient-reported outcomes and pain improvements after hip arthroscopy.
Methods
- Sixty-five patients (74 hips) had preoperative dGEMRIC imaging before primary hip arthroscopy (2008–2012).
- Patients were grouped based on dGEMRIC index cutoff of 323 msec (1 SD below cohort mean).
- Outcome measures included mHHS, NAHS, HOS-ADL, HOS-SSS, pain VAS, and patient satisfaction at two years.
Key Findings
- 52 hips had dGEMRIC ≥323 msec; 12 hips had <323 msec.
- Both groups had similar baseline demographics and preoperative scores.
- At two years, the higher dGEMRIC group showed significant improvement across all outcomes; the lower dGEMRIC group only improved significantly in mHHS.
- Improvement magnitude was significantly greater in the higher dGEMRIC group.
- No difference in patient satisfaction or correlation between dGEMRIC and outcomes.
Conclusion
Patients with better preoperative cartilage quality (dGEMRIC ≥323 msec) experience greater improvements in function and pain after hip arthroscopy.
What This Means for Patients
Advanced imaging of cartilage before surgery may help predict how much patients will benefit from hip arthroscopy.