Novel three-dimensional MRI technique for study of cartilaginous hip surfaces in Legg-Calvé-Perthes disease

David Pienkowski, Joanne Resig, Vishwas Talwalkar, Chester Tylkowski

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

Abstract

Treatment of Legg-Calvé-Perthes disease (LCPD) may improve if new knowledge can be obtained regarding how articular cartilage changes shape during the course of this disorder.Anew technique is presented showinghowanalyses of magnetic resonance images can be used to quantify the three-dimensional changes in the femoral and acetabular articulating cartilage surfaces of children with LCPD. Ten male subjects (8±1 years) with unilateral LCPD were enrolled in this IRB approved study. Sets of magnetic resonance images of both hips were obtained at three different times. Three-dimensional virtual models of the cartilage were created from these images, and mathematical spheres were fit to the articulating surfaces. Five parameters (size, shape deformity (sphericity error), radial growth rate, joint fit, and joint incongruity)were used to quantify cartilage surface shape. Datawere analyzed by using a linear mixed-model. Joint incongruity, i.e., the distance between the centers of the femoral and acetabular spheres, was slightly more than 2.5 times larger (p = 0.001) inLCPD hips than the contralateral normal hips. Cartilage shape deformity was 65% larger in hips with LCPD than in normal hips. Growth rates of the femoral head and the opposing acetabular surface showed that distortion of the femoral surface occurred first and the opposing acetabular surface followed. Mean radial difference (acetabular surface radius minus femoral surface radius) in LCPD hips was less than half (p < 0.01) the value of normal hips. Interobserver variability was ∼10% of the value attributable to LCPD. This is the first known report presenting a technique that quantifies the three-dimensional size, deformity, growth, fit. and incongruity of the femoral and acetabular articulating cartilaginous surfaces ofLCPDand contralateral normal hips. The data obtained support the use of this technique and provide pilot data for a future clinical study of LCPD. Objective assessment of cartilage shape enabled by this techniquemayaid future diagnoses, enable monitoring of three-dimensional femoral and acetabular remodeling, and permit quantitative assessment of treatment efficacy.

Original languageEnglish
Pages (from-to)981-988
Number of pages8
JournalJournal of Orthopaedic Research
Volume27
Issue number8
DOIs
StatePublished - Aug 2009

Keywords

  • Cartilage shape
  • Hip
  • Image analyses
  • Joint shape
  • Perthes

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

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