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Bugeja JM, Xia Y, Chandra SS, Murphy NJ, Crozier S, Hunter DJ, Fripp J, Engstrom C. Analysis of cam location characteristics in FAI syndrome patients from 3D MR images demonstrates sex-specific differences. J Orthop Res 2024; 42:385-394. [PMID: 37525546 DOI: 10.1002/jor.25674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 06/22/2023] [Accepted: 07/26/2023] [Indexed: 08/02/2023]
Abstract
Cam femoroacetabular impingement (FAI) syndrome is associated with hip osteoarthritis (OA) development. Hip shape features, derived from statistical shape modeling (SSM), are predictive for OA incidence, progression, and arthroplasty. Currently, no three-dimensional (3D) SSM studies have investigated whether there are cam shape differences between male and female patients, which may be of potential clinical relevance for FAI syndrome assessments. This study analyzed sex-specific cam location and shape in FAI syndrome patients from clinical magnetic resonance examinations (M:F 56:41, age: 16-63 years) using 3D focused shape modeling-based segmentation (CamMorph) and partial least squares regression to obtain shape features (latent variables [LVs]) of cam morphology. Two-way analysis of variance tests were used to assess cam LV data for sex and cam volume severity differences. There was no significant interaction between sex and cam volume severity for the LV data. A sex main effect was significant for LV 1 (cam size) and LV 2 (cam location) with medium to large effect sizes (p < 0.001, d > 0.75). Mean results revealed males presented with a superior-focused cam, whereas females presented with an anterior-focused cam. When stratified by cam volume, cam morphologies were located superiorly in male and anteriorly in female FAI syndrome patients with negligible, mild, or moderate cam volumes. Both male and female FAI syndrome patients with major cam volumes had a global cam distribution. In conclusion, sex-specific cam location differences are present in FAI syndrome patients with negligible, mild, and moderate cam volumes, whereas major cam volumes were globally distributed in both male and female patients.
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Affiliation(s)
- Jessica M Bugeja
- Australian e-Health Research Centre, Health and Biosecurity, Commonwealth Scientific and Industrial Research Organisation, Brisbane, QLD, Australia
| | - Ying Xia
- Australian e-Health Research Centre, Health and Biosecurity, Commonwealth Scientific and Industrial Research Organisation, Brisbane, QLD, Australia
| | - Shekhar S Chandra
- School of Information Technology and Electrical Engineering, Faculty of Engineering, Architecture and Information Technology, The University of Queensland, Brisbane, QLD, Australia
| | - Nicholas J Murphy
- Kolling Institute of Medical Research, Sydney Musculoskeletal Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Department of Orthopaedic Surgery, John Hunter Hospital, Newcastle, NSW, Australia
| | - Stuart Crozier
- School of Information Technology and Electrical Engineering, Faculty of Engineering, Architecture and Information Technology, The University of Queensland, Brisbane, QLD, Australia
| | - David J Hunter
- Kolling Institute of Medical Research, Sydney Musculoskeletal Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Department of Rheumatology, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Jurgen Fripp
- Australian e-Health Research Centre, Health and Biosecurity, Commonwealth Scientific and Industrial Research Organisation, Brisbane, QLD, Australia
| | - Craig Engstrom
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD, Australia
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Blum S, Franken L, Hartmann A, Thielemann F, Plodeck V, Danowski D, Kühn JP, Hoffmann RT, Günther KP, Goronzy J. MRI-based static and functional assessment of complex hip deformities in comparison with CT: a validation study. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2020; 33:829-838. [PMID: 32323031 PMCID: PMC7669781 DOI: 10.1007/s10334-020-00845-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 03/03/2020] [Accepted: 04/07/2020] [Indexed: 11/29/2022]
Abstract
Objective This study aimed at investigating the agreement between predefined quantitative parameters of hip morphology derived from magnetic resonance imaging (MRI) and virtual range of motion (ROM) analysis using computed tomography (CT) as standard of reference. Methods Twenty patients (13 females, 7 males, 16–59 years) with hip deformities underwent MRI prior to surgery. Clockwise alpha angle, femoral head and neck diameter, collum caput diaphysis angle, femoral torsion, center-edge angles, acetabular coverage of the femoral head, sourcil angle, and acetabular anteversion were measured. Additionally, tern single and combined movements were simulated using a motion analysis program. The MRI findings were compared with the corresponding results obtained by CT. Correlation of MRI with CT was assessed using different statistical methods (intraclass correlation coefficient, Bland–Altmann plot, two one-sided t test), and linear regression analysis was performed. Results The results showed near-perfect intraclass correlation coefficients (ICCs) for anteversion (0.95), acetabular sector angles (0.98–0.99), sourcil angle (0.95), and acetabular coverage (anterior 0.96, posterior 0.99). Intermethod correlation for femoral parameters showed almost perfect agreement except for the alpha angle (0.73–0.97). No significant proportional bias was detected for traditional acetabular and femoral parameters. ROM analysis was performed for 370 movements in 37 hips. For 78.4% (290/370) of the movements analysed, neither CT nor MRI detected impingement across the physiological ROM. For 18.6% (69/370) of the movements, impingement was detected by both CT and MRI, while 2.2% (8/370) of the movements with impingement in CT showed no impingement in MRI, and 0.8% (3/370) of the movements with impingement in MRI had no corresponding result in CT. Conclusion Finally, it was concluded that MRI-based assessment of hip morphology and virtual ROM analysis is feasible and can be performed with good intermethod agreement in comparison to the gold standard (CT). Therefore, MRI appears to be substantially equivalent to CT for use in virtual ROM analysis and so may reasonably be used in place of CT for this purpose.
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Affiliation(s)
- Sophia Blum
- Department of Radiology, Institute and Policlinic of Diagnostic and Interventional Radiology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
| | - Lea Franken
- University Center of Orthopedics and Traumatology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Albrecht Hartmann
- University Center of Orthopedics and Traumatology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Falk Thielemann
- University Center of Orthopedics and Traumatology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Verena Plodeck
- Department of Radiology, Institute and Policlinic of Diagnostic and Interventional Radiology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Dirk Danowski
- Department of Radiology, Institute and Policlinic of Diagnostic and Interventional Radiology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Jens-Peter Kühn
- Department of Radiology, Institute and Policlinic of Diagnostic and Interventional Radiology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Ralf-Thorsten Hoffmann
- Department of Radiology, Institute and Policlinic of Diagnostic and Interventional Radiology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Klaus-Peter Günther
- University Center of Orthopedics and Traumatology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Jens Goronzy
- University Center of Orthopedics and Traumatology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
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Zhang H, Belev G, Stewart RC, Grinstaff MW, Snyder BD, Wilson DR. Protocol development for synchrotron contrast-enhanced CT of human hip cartilage. Med Eng Phys 2019; 73:1-8. [PMID: 31526590 DOI: 10.1016/j.medengphy.2019.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 07/11/2019] [Accepted: 08/21/2019] [Indexed: 11/24/2022]
Abstract
Understanding hip osteoarthritis requires new investigational tools for quantitative studies of biophysical and biomechanical properties as well as for determination of structure. Three new protocols to study pathological changes in cartilage and to measure cartilage thickness in intact human hips are described using synchrotron contrast enhanced computed tomography (sCECT) with the iodinated contrast agent CA4+. Ten human cadaver hips were prepared and injected with CA4+ using three different methods, all of which included rotation and distraction of the joint. CA4+ diffusion into cartilage was monitored using sCECT. The thickness of acetabular and femoral cartilage was also measured. Diffusion times ranged from 2 h to 75 h, depending on the injection protocol and the cartilage region. Direct single injection of the contrast through the labrum resulted in the fastest diffusion times. The iodine attenuation coefficient, which reflects the contrast agent distribution in the cartilage, ranged from 0.0142/cm to 0.1457/cm. Three injections at the head/neck conjunction area yielded the highest iodine attenuation coefficients in cartilage. The femoral cartilage in the Superior-Medial compartment was significantly thicker than in the other 3 femoral compartments, and femoral cartilage in the Superior-Anterior compartment was significantly thinner than the other 3 femoral compartments. The acetabular cartilage in the Superior compartment was significantly thicker than that in the Superior-Posterior compartment. sCECT with CA4+ allows assessment of hip cartilage thickness with 0.1 mm isotropic voxel size, sufficient for evaluating cartilage pathology and biomechanics.
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Affiliation(s)
- Honglin Zhang
- Department of Orthopaedics, University of British Columbia, Centre for Hip Health and Mobility, 2635 Laurel St, Vancouver BC V5Z 1M9, Canada
| | - George Belev
- Canadian Light Source, 44 Innovation Blvd, Saskatoon, SK S7N 2V3, Canada
| | - Rachel C Stewart
- Departments of Biomedical Engineering and Chemistry, Boston University, 403-44 Cummington Mall, Boston, MA 02215, USA
| | - Mark W Grinstaff
- Departments of Biomedical Engineering and Chemistry, Boston University, 403-44 Cummington Mall, Boston, MA 02215, USA
| | - Brian D Snyder
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave., RN 115, Boston, MA 02215, USA
| | - David R Wilson
- Department of Orthopaedics, University of British Columbia, Centre for Hip Health and Mobility, 2635 Laurel St, Vancouver BC V5Z 1M9, Canada.
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Xia Y, Fripp J, Chandra SS, Walker D, Crozier S, Engstrom C. Automated 3D quantitative assessment and measurement of alpha angles from the femoral head-neck junction using MR imaging. Phys Med Biol 2015; 60:7601-16. [DOI: 10.1088/0031-9155/60/19/7601] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Chhabra A, Nordeck S, Wadhwa V, Madhavapeddi S, Robertson WJ. Femoroacetabular impingement with chronic acetabular rim fracture - 3D computed tomography, 3D magnetic resonance imaging and arthroscopic correlation. World J Orthop 2015; 6:498-504. [PMID: 26191497 PMCID: PMC4501936 DOI: 10.5312/wjo.v6.i6.498] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2015] [Revised: 03/13/2015] [Accepted: 06/08/2015] [Indexed: 02/06/2023] Open
Abstract
Femoroacetabular impingement is uncommonly associated with a large rim fragment of bone along the superolateral acetabulum. We report an unusual case of femoroacetabular impingement (FAI) with chronic acetabular rim fracture. Radiographic, 3D computed tomography, 3D magnetic resonance imaging and arthroscopy correlation is presented with discussion of relative advantages and disadvantages of various modalities in the context of FAI.
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