The University of Sydney, Sydney Musculoskeletal Health and the Kolling Institute, Faculty of Medicine and Health and the Northern Sydney Local Health District, Sydney, Australia.
Department of Orthopaedic Surgery, John Hunter Hospital, New Lambton Heights, Australia.
J Orthop Res. 2023 Nov;41(11):2484-2494. doi: 10.1002/jor.25568. Epub 2023 Apr 12.
This study sought to explore, in people with symptoms, signs and imaging findings of femoroacetabular impingement (FAI syndrome): (1) whether more severe labral damage, synovitis, bone marrow lesions, or subchondral cysts assessed on magnetic resonance imaging (MRI) were associated with poorer cartilage health, and (2) whether abnormal femoral, acetabular, and/or combined femoral and acetabular versions were associated with poorer cartilage health. This cross-sectional study used baseline data from the 50 participants with FAI syndrome in the Australian FASHIoN trial (ACTRN12615001177549) with available dGEMRIC scans. Cartilage health was measured using delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) score sampled at the chondrolabral junction on three midsagittal slices, at one acetabular and one femoral head region of interest on each slice, and MRI features were assessed using the Hip Osteoarthritis MRI Score. Analyses were adjusted for alpha angle and body mass index, which are known to affect dGEMRIC score. Linear regression assessed the relationship with the dGEMRIC score of (i) selected MRI features, and (ii) femoral, acetabular, and combined femoral and acetabular versions. Hips with more severe synovitis had worse dGEMRIC scores (partial η = 0.167, p = 0.020), whereas other MRI features were not associated. A lower combined femoral and acetabular version was associated with a better dGEMRIC score (partial η = 0.164, p = 0.021), whereas isolated measures of femoral and acetabular version were not associated. In conclusion, worse synovitis was associated with poorer cartilage health, suggesting synovium and cartilage may be linked to the pathogenesis of FAI syndrome. A lower combined femoral and acetabular version appears to be protective of cartilage health at the chondrolabral junction.
本研究旨在探讨有髋关节撞击综合征(FAI 综合征)症状、体征和影像学表现的人群中:(1) 磁共振成像(MRI)评估的更严重的盂唇损伤、滑膜炎、骨髓病变或软骨下囊肿是否与软骨健康状况较差相关,以及(2) 异常的股骨、髋臼和/或股骨髋臼联合角度是否与软骨健康状况较差相关。这项横断面研究使用了澳大利亚 FASHIoN 试验(ACTRN12615001177549)中 50 名 FAI 综合征患者的基线数据,这些患者可进行 dGEMRIC 扫描。软骨健康状况采用延迟钆增强 MRI 软骨(dGEMRIC)评分进行评估,在三个正中矢状位切片的软骨盂唇交界处、每个切片的一个髋臼和一个股骨头区域进行采样,MRI 特征采用髋关节骨关节炎 MRI 评分进行评估。分析调整了已知影响 dGEMRIC 评分的 α角和体重指数。线性回归评估了以下因素与 dGEMRIC 评分的关系:(i) 选定的 MRI 特征,和(ii) 股骨、髋臼和股骨髋臼联合角度。滑膜炎更严重的髋关节 dGEMRIC 评分较差(偏 η =0.167,p=0.020),而其他 MRI 特征与 dGEMRIC 评分无相关性。较低的股骨髋臼联合角度与更好的 dGEMRIC 评分相关(偏 η =0.164,p=0.021),而单独的股骨和髋臼角度测量与 dGEMRIC 评分无相关性。总之,更严重的滑膜炎与软骨健康状况较差相关,提示滑膜炎和软骨可能与 FAI 综合征的发病机制有关。较低的股骨髋臼联合角度似乎对软骨盂唇交界处的软骨健康具有保护作用。