Acetabular Delamination: Epidemiology, Histological Features, and Treatment

Jannelli, Eugenio; Parafioriti, Antonina; Acerbi, Alberto; Ivone, Alessandro; Fioruzzi, Alberto; Fontana, A.

doi:10.1177/1947603518768096

Cited by 23 publications

(44 citation statements)

References 33 publications

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“…Microscopic degenerative OA changes in head-neck and acetabular cartilage have been reported previously. 18,23,28,33,37 The current study is distinct and among the first published because it includes cartilage from the head-neck and acetabulum as well as the synovium from patients with early-stage FAI, patients with late-stage OA secondary to FAI, and healthy controls. Moreover, all samples were characterized with H&E staining, safranin-O staining, and immunostaining for inflammation-related markers.…”

Section: Discussionmentioning

confidence: 99%

Distinct Pattern of Inflammation of Articular Cartilage and the Synovium in Early and Late Hip Femoroacetabular Impingement

et al. 2020

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Background: The molecular mechanism of how femoroacetabular impingement (FAI) morphology leads to hip osteoarthritis (OA) is yet to be determined. The expression and location of inflammation-related molecules during early- and late-stage FAI have not been previously described. Moreover, the characterization of intra-articular inflammation away from the cam deformity as well as the nature of adjacent synovial tissue have also not been extensively reported. Hypothesis: Early-stage FAI has a similar expression of inflammation-related markers in the head-neck and acetabular cartilage but less synovitis than late-stage FAI. Study Design: Controlled laboratory study. Methods: Head-neck cartilage, acetabular cartilage, and synovial samples were obtained from patients undergoing hip preservation surgery for the treatment of symptomatic cam FAI (early FAI group; n = 15) and advanced OA secondary to cam FAI (late FAI group; n = 15). Samples procured from healthy young adult donors served as the control group (n = 7). Cartilage degeneration was assessed by histology, and the expression of inflammation-related proteins (interleukin–1 beta [IL-1β], matrix metalloproteinase–13 [MMP-13], a disintegrin and metalloproteinase with thrombospondin motifs–4 [ADAMTS-4], type II collagen [COL2], and aggrecan neoepitope [NITEGE]) was measured by immunostaining. Synovial samples in the early and late FAI groups were examined for synovitis and the expression of IL-1β. Results: Head-neck cartilage in the early FAI group showed significantly more degeneration than the control group and an increased expression of inflammation-related proteins (IL-1β: 69.7% ± 18.1% vs 20.2% ± 4.9%, respectively; MMP-13: 79.6% ± 12.6% vs 25.3% ± 9.5%; ADAMTS-4: 83.9% ± 12.2% vs 24.3% ± 11.1%; NITEGE: 89.7% ± 7.7% vs 39.8% ± 20.5%) ( P < .001). Head-neck and acetabular cartilage in the early and late FAI groups showed a similar degree of degeneration. Moreover, a similar expression of inflammation-related proteins was observed between the early and late FAI groups for head-neck cartilage (IL-1β: 69.7% ± 18.1% vs 72.5% ± 13.2%; MMP-13: 79.6% ± 12.6% vs 71.4% ± 18.8%; ADAMTS-4: 83.9% ± 12.2% vs 82.6% ± 12.5%; COL2: 93.6% ± 3.9% vs 92.5% ± 5.8%; NITEGE: 89.7% ± 7.7% vs 95.7% ± 4.7%) and acetabular cartilage (IL-1β: 83.3% ± 24.8% vs 80.7% ± 15.6%; MMP-13: 94.3% ± 9.7% vs 85.2% ± 12.3%; ADAMTS-4: 98.5% ± 2.3% vs 98.4% ± 3.4%; COL2: 99.8% ± 0.7% vs 99.7% ± 1.1%; NITEGE: 96.7% ± 6.7% vs 99.2% ± 2.2%). In contrast, synovitis was minimal with a low expression of IL-1β in the early FAI group compared with the late FAI group. Conclusion: Hip cartilage exhibited an OA phenotype in patients with early-stage FAI, similar to what was observed in hip OA secondary to FAI. Severe synovitis was only evident with late-stage FAI. Clinical Relevance: This study supports the concept that early hip impingement is associated with cartilage degeneration and catabolism.

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Section: Discussionmentioning

confidence: 99%

Distinct Pattern of Inflammation of Articular Cartilage and the Synovium in Early and Late Hip Femoroacetabular Impingement

et al. 2020

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“…And in severe acetabular overcoverage, "contrecoup" lesions of the posteroinferior femoroacetabular cartilage can be observed. 3,14,18,26 Commonly a combination of cam and pincer morphology is seen with overlapping damage patterns and occurs more frequently in male subjects. Additional extra-articular factors such as abnormal femoral torsion may be present.…”

Section: Intra-articular Hip Impingement: Femoroacetabular Impingementmentioning

confidence: 99%

“…Associated BME anterior inferiorly in the pubic bone is common and was reported in > 50% of patients with athletic pubalgia (►Figs. [14][15][16]. Other imaging signs are edema or atrophy of the rectus abdominis muscle attachment.…”

Section: Athletic Pubalgiamentioning

confidence: 99%

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Imaging of Articular and Extra-articular Sports Injuries of the Hip

Borić

Isaac

Dalili

et al. 2019

Semin Musculoskelet Radiol

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Sports-related articular and periarticular hip injuries are common in athletes. Knowledge of patient complaints and clinical findings are crucial for adequate interpretation of imaging examinations. However, asymptomatic athletes can present abnormal imaging findings, and clinical presentation of hip injuries may be nonspecific. Therefore, a thorough examination of the hip and surrounding soft tissue images is essential.This review describes the intra-articular pathologies encountered in sports activities including labrum or cartilage lesions, associated or not with femoroacetabular hip impingement syndromes, as well as ligament teres injuries, using magnetic resonance imaging (MRI) or computed tomography arthrography. Different causes of snapping hip syndrome (from intra- and extra-articular origins) are also discussed and illustrated. The extra-articular forms of hip impingement syndromes including ischiofemoral and subspine impingement are depicted with MRI and ultrasound. Diagnostic imaging of bone avulsions, greater trochanteric syndrome, athletic pubalgia, and myotendinous injuries is also described.

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“…Shearing injuries were suspected to be the cause for delamination. For example, shear forces could explain the high frequency of delaminating cartilage lesions in the acetabulum 66 in patients with cam impingement. However, people who show sponta-neous delamination in the knee usually have no history of abnormal stress or trauma.…”

Section: Cartilage Delaminationmentioning

confidence: 99%

Perspective on Idiopathic Subchondral, Osteochondral, and Chondral Lesions with Emphasis on the Knee

Fischer¹

2019

Semin Musculoskelet Radiol

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Subchondral, osteochondral, and chondral lesions of unknown cause are often encountered, especially in the knee joint. These are mainly idiopathic bone marrow edema syndrome, osteochondrosis dissecans, and cartilage delaminations. The literature on these diseases is sparse and often confusing and inconsistent. Because there is little evidence, this article was written as a perspective on these conditions. It offers an overview of the literature with personal comments and opinions based on observations from many years of clinical practice. The main goal is to highlight clinically important features and provide a practical guide for dealing with various magnetic resonance imaging findings in everyday work. The article also discusses several terms commonly used in relation to these diseases and their differential diagnoses.

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Acetabular Delamination: Epidemiology, Histological Features, and Treatment

Cited by 23 publications

References 33 publications

Distinct Pattern of Inflammation of Articular Cartilage and the Synovium in Early and Late Hip Femoroacetabular Impingement

Distinct Pattern of Inflammation of Articular Cartilage and the Synovium in Early and Late Hip Femoroacetabular Impingement

Imaging of Articular and Extra-articular Sports Injuries of the Hip

Perspective on Idiopathic Subchondral, Osteochondral, and Chondral Lesions with Emphasis on the Knee

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