Document Detail

dGEMRIC as a tool for measuring changes in cartilage quality following high tibial osteotomy: a feasibility study.
MedLine Citation:
PMID:  22796509     Owner:  NLM     Status:  Publisher    
OBJECTIVE: The high tibial osteotomy (HTO) is an effective strategy for treatment of painful medial compartment knee osteoarthritis. Effects on cartilage quality are largely unknown. Delayed Gadolinium-Enhanced MRI of Cartilage (dGEMRIC) enables non-invasive assessment of cartilage glycosaminoglycan content. This study aimed to evaluate if dGEMRIC could detect relevant changes in cartilage glycosaminoglycan content following HTO. DESIGN: Ten patients with medial compartment osteoarthritis underwent a dGEMRIC scan prior to HTO, and after bone healing and subsequent hardware removal. A dGEMRIC index (T(1)Gd) was used for changes in cartilage glycosaminoglycan content, a high T(1)Gd indicating a high glycosaminoglycan content and vice versa. Radiographic analysis included mechanical axis and tibial slope measurement. Clinical scores (KOOS, VAS, KSCRS) before, 3 and 6 months after HTO and after hardware removal were correlated to T(1)Gd changes. RESULTS: Overall a trend towards a decreased T(1)Gd, despite HTO, was observed. Before and after HTO, lateral femoral condyle T(1)Gd was higher than medial femoral condyle (MFC) T(1)Gd and tibial cartilage T(1)Gd was higher than that of femoral cartilage (p<0.001). The MFC had the lowest T(1)Gd before and after HTO. Clinical scores all improved significantly (p<0.01), KOOS Symptoms and QOL were moderately related to changes in MFC T(1)Gd. CONCLUSIONS: dGEMRIC effectively detected differences in cartilage quality within knee compartments before and after HTO, but no changes due to HTO were detected. Hardware removal post-HTO seems essential for adequate T(1)Gd interpretation. T(1)Gd was correlated to improved clinical scores on a subscore level only. Longer follow-up after HTO may reveal lasting changes.
M Rutgers; L W Bartels; A I Tsuchida; R M Castelein; W J Dhert; K L Vincken; R J van Heerwaarden; D B F Saris
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-10
Journal Detail:
Title:  Osteoarthritis and cartilage / OARS, Osteoarthritis Research Society     Volume:  -     ISSN:  1522-9653     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9305697     Medline TA:  Osteoarthritis Cartilage     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012. Published by Elsevier Ltd.
Orthopaedics department, University Medical Center Utrecht.
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