Abstract
Cam-type femoral acetabular impingement (FAI), is a common structural hip deformity and thought to be a leading cause of early hip osteoarthritis. Although patients who undergo surgical correction notice improved clinical function it is unclear what impact this has on the overall health of the cartilage. T1rho MRI cartilage mapping has been shown to be a reliable imaging technique to assess the proteoglycan (PG) content potentially serving as a biomarker. This study analyses post surgical changes in T1rho levels in hip joints treated with cam FAI.
Eleven patients with a mean age of 38 (all males) underwent pre and post T1Rho Cartilage mapping of their hips at a mean time of 20 months post surgical intervention. The acetabulum was spatially divided into 4 main regions of interest (ROI), with levels of T1Rho in cartilage quantified as a whole and in each spatial segment. T1Rho signal is inversely correlated with level of PG content.
All patients demonstrated loss of PG content on pre-op imaging with a T1Rho of 33.5ms+2.6ms. Preop T1rho levels were found to significantly correlated with the difference between pre-op and post-op T1rho in entire hip cartilage (R: 0.73; p=0.016). This correlation was reflected both in the anterolateral quadrant (R: 0.86; p=0.002), and in the posteriosuperior quadrant (R:0.70; p=0.035). Additionally, significant correlation was found between improvement of WOMAC pain score over time, and difference of T1rho values over time in the most lateral 3mm slice of the anterolateral quadrant (R: 0.81; p=0.045). Significant correlation was found between pre-op alpha angle at 1:30 and difference between pre-op and post-op total cartilage T1rho content (R: −065;p=0.038).
T1Rho Cartilage mapping of the hip is a useful biomarker in the assessment of the surgical management of Cam type FAI. This preliminary data provides some evidence that surgical correction of the deformity can help minimise disease progression.
