Longitudinal Assessment of the Effects of Hip Arthroscopy on Articular Cartilage Biochemistry through a Novel Quantitative MRI-Based Approach

通过基于 MRI 的新型定量方法纵向评估髋关节镜检查对关节软骨生物化学的影响

• 批准号: 9191190
• 负责人: Michael A Samaan
• 金额: $ 6.25万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-01 至 2018-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9191190
• 关键词: Activities of Daily Living; Affect; Arthritis; Arthroscopy; Articular Range of Motion; Biochemistry; California; Cartilage; Clinical; Collagen; Deformity; Degenerative Disorder; Degenerative polyarthritis; Educational workshop; Enrollment; Environment; Faculty; Goals; Grant; Group Meetings; Head; Head and neck structure; Health; Hip Joint; Hip region structure; Image; Image Analysis; Institutes; International; Intervention; Investigation; Knee joint; Knowledge; Limb structure; Magnetic Resonance Imaging; Measurement; Measures; Methods; Mission; Motion; Musculoskeletal; Musculoskeletal Diseases; National Institute of Arthritis and Musculoskeletal and Skin Diseases; Operative Surgical Procedures; Orthopedics; Outcome; Pain; Pathology; Patient Self-Report; Patients; Performance; Physical Performance; Physical activity; Physically Handicapped; Positioning Attribute; Process; Proteoglycan; Questionnaires; Recruitment Activity; Relaxation; Research; Research Personnel; Resources; Risk; Surgeon; Surveys; Techniques; Testing; Time; Universities; Walking; Work; Writing; abstracting; acetabulum; articular cartilage; base; cartilage degradation; clinically significant; disability; functional outcomes; image processing; image registration; improved; joint function; knowledge base; musculoskeletal imaging; novel; primary outcome; quantitative imaging; secondary outcome; skills; skin disorder; soft tissue; tenure track; time use; tool

Abstract/Project Summary Femoroacetabular impingement (FAI) is a morphological deformation of the hip joint that reduces hip range of motion, function, etc. and results in increased pain and disability. The FAI pathology consists of three various sub-types: cam, pincer and mixed (cam & pincer), with the cam-type being present in approximately 48% of those with radiographic signs of FAI. Symptomatic FAI patients usually undergo hip arthroscopy in order to surgically correct for these morphological deformations. In this study, the hip joint cartilage health and joint function of symptomatic cam-type FAI patients that will undergo hip arthroscopy will be assessed over a six month time period. The patients recruited in this study will undergo a unilateral hip MRI of the affected limb as well as undergo functional assessment (self-reported outcomes and physical performance) both prior to and at 6 months after hip femoroplasty, a form of hip arthroscopy used to treat cam-type FAI. The main outcome of this project (Aim 1) is to assess hip joint articular cartilage health (T1ρ and T2 relaxation times) using a novel voxel based relaxometry (VBR) method. The VBR method has been previously established for use in the knee joint and the applicant will seek to establish a VBR method for use in the hip joint. It is hypothesized that after hip arthroscopy hip cartilage T1ρ and T2 relaxation times will be altered compared to the baseline (pre- surgery) relaxation times. Aim 2 of the study (secondary outcomes) will assess functional performance and self-reported outcomes of pain, disability and determine the possible associations between these measures with the VBR based assessment of T1ρ and T2 relaxation times. Functional performance will be assessed using the timed up and go (TUG) and the six minute walk test (6MWT), while self-reported outcomes of pain, physical activity, disability, etc. will be assessed using the HOOS, Harris Hip surveys and the IPAQ. It is hypothesized that patients will demonstrate improved functional performance and self-reported levels of pain, physical activity and disability. In order to accomplish the goals of this study and supplement the candidate’s knowledge base, the candidate will enroll in three courses at the University of California (UCSF) to obtain knowledge in image-based processing. These courses are Image Processing I&II and Musculoskeletal Imaging and will provide the candidate with the knowledge and skills necessary in developing various image analysis applications that will be necessary in achieving the goals of this project. In addition to these courses, the candidate will take advantage of the educational and professional resources (i.e. grant writing workshops, biweekly group meetings/image review, etc.) that are organized and provided by UCSF. Also, the Musculoskeletal Quantitative Imaging Research (MQIR) group, the group that the applicant currently works in, hosts bi-weekly image review and group meetings in which the applicant will be exposed to various clinical and analytical interpretations and applications of musculoskeletal imaging. The physical resources, intellectual and institutional support available at UCSF and within the MQIR group will not only provide an excellent environment for the candidate to succeed in accomplishing the goals of this study but will provide the candidate with the initial steps in obtaining a tenure-track faculty position. The results of this study will help researchers and clinicians to better understand the effects of hip arthroscopy on hip joint health and function as well as support the mission statement of the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). Also, the knowledge obtained from the results of this study will help orthopaedic surgeons to better understand and improve upon current methods used in hip arthroscopy.

摘要/项目摘要 股骨髋臼撞击（FAI）是髋关节的一种形态学变形， 运动、功能等，并导致疼痛和残疾增加。FAI病理学包括三种不同的 子类型：凸轮，钳子和混合（凸轮和钳子），凸轮型约占48%， 有放射学FAI征象者。有症状的FAI患者通常接受髋关节镜检查， 通过外科手术矫正这些形态学变形。在这项研究中，髋关节软骨健康和关节 将接受髋关节镜检查的症状性凸轮型FAI患者的功能将在6个月内进行评估。 月时间段。本研究招募的患者将接受患肢的单侧髋关节MRI， 以及在术前和术后接受功能评估（自我报告的结果和身体表现） 髋关节股骨成形术后6个月，一种用于治疗凸轮型FAI的髋关节镜手术。的主要成果 本项目（目标1）是使用一种新的方法评估髋关节关节软骨的健康状况（T1ρ和T2弛豫时间）。 基于体素的弛豫测量（VBR）方法。VBR方法先前已被确立用于膝关节 申请人将寻求建立用于髋关节的VBR方法。据推测， 髋关节镜检查髋关节软骨T1ρ和T2弛豫时间将与基线（术前）相比发生改变。 手术）放松时间。本研究的目标2（次要结局）将评估功能性能， 自我报告的疼痛，残疾的结果，并确定这些措施之间的可能关联 利用基于VBR的T1ρ和T2弛豫时间评估。将评估功能性能 使用定时起身和行走（TUG）和六分钟步行测试（6 MWT），而自我报告的疼痛结果， 将使用HOOS、Harris髋关节调查和IPAQ评估身体活动、残疾等。是 假设患者将表现出改善的功能表现和自我报告的疼痛水平， 身体活动和残疾。 为了完成本研究的目标，并补充候选人的知识基础，候选人 我将参加加州大学（UCSF）的三门课程，以获得基于图像的知识。 处理.这些课程是图像处理I&II和肌肉骨骼成像，并将提供 具有开发各种图像分析应用程序所需的知识和技能的候选人， 是实现本项目目标的必要条件。除了这些课程，候选人还将参加 教育和专业资源的优势（即资助写作研讨会、双周小组 会议/图像审查等）由加州大学旧金山分校组织和提供。此外，肌肉骨骼定量 成像研究（MQIR）组，申请人目前所在的组，每两周进行一次图像审查 和小组会议，申请人将在这些会议上接触各种临床和分析解释， 肌肉骨骼成像的应用。现有的物质资源、智力和体制支持 在UCSF和MQIR小组内，不仅为候选人提供了一个良好的环境， 成功实现本研究的目标，但将为候选人提供获得的初步步骤 终身教职这项研究的结果将有助于研究人员和临床医生更好地了解 髋关节镜对髋关节健康和功能的影响，并支持 国家关节炎、肌肉骨骼和皮肤病研究所（NIAMS）。此外，获得的知识 本研究的结果将有助于骨科医生更好地了解和改善目前的 髋关节镜检查的方法。