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Does the dGEMRIC Index Recover 3 Years After Surgical FAI Correction and an Initial dGEMRIC Decrease at 1-Year

Malin Kristin Meier1, Samira Scheuber1, Markus Simon Hanke1

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Delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) showed improved cartilage quality 3 years after femoroacetabular impingement (FAI) surgery. This contrasts with initial declines, suggesting recovery of joint health post-FAI correction.

Keywords:
MRIdGEMRICfemoroacetabular impingementhip

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Area of Science:

  • Orthopedics
  • Radiology
  • Biomedical Engineering

Background:

  • Delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) offers noninvasive assessment of cartilage quality.
  • Previous interim analysis indicated a dGEMRIC index decrease 1 year post-femoroacetabular impingement (FAI) correction, despite positive clinical outcomes.

Purpose of the Study:

  • To longitudinally evaluate dGEMRIC indices in patients treated for FAI, comparing operative versus nonoperative management.
  • To track changes in cartilage quality over 3 years using dGEMRIC.

Main Methods:

  • A prospective, comparative longitudinal study included 39 patients (40 hips) with FAI, divided into operative and nonoperative groups.
  • Indirect magnetic resonance arthrography was performed at baseline, 1 year, and 3 years.
  • Deep learning software was used for 3D cartilage models, with dGEMRIC indices calculated for acetabular and femoral cartilage.

Main Results:

  • The operative group demonstrated a significant decrease in dGEMRIC indices from baseline to 1 year (acetabular: 512 to 392 ms; femoral: 530 to 411 ms; P < .001).
  • From 1 to 3 years, dGEMRIC indices improved significantly in the operative group (acetabular: 392 to 456 ms; femoral: 411 to 477 ms; P < .001).
  • The nonoperative group showed no significant changes in dGEMRIC indices at any time point.

Conclusions:

  • Three years after FAI correction, dGEMRIC indices improved compared to the 1-year follow-up, indicating cartilage quality recovery.
  • This improvement may be attributed to normalized joint biomechanics or resolution of postoperative inflammatory processes following intra-articular surgery.