The overall goal of this proposal is to evaluate cartilage composition of patients with hip osteoarthritis (OA) using advanced MRI techniques, and determine their relationship to development of cartilage lesions, patient function, and changes in hip kinematics and kinetics during functional tasks. The central hypothesis is that early changes in cartilage biochemistry and altered hip biomechanics are associated with progression of hip OA defined by worsening patient-reported outcomes and higher cartilage lesion scores. To accomplish this we need to establish the cross-sectional relationship of these metrics and natural history of hip OA over three years with the following specific aims:
Aim I) To characterize hip cartilage T1? and T2 relaxation time, their spatial heterogeneity and anatomical location, and association of hip geometry (i.e. alpha angle, acetabular depth, etc), as a function of (I.A) KL grade and (I.B) annual follow-up time (Years 0-3);
Aim II) To determine the relationship between hip cartilage composition (measured by MR T1? and T2 relaxation time, spatial heterogeneity, their anatomical location - Aim I outcomes) and disease progression as measured by (IIA) hip joint morphology (see Fig. 1- semi-quantitative MR grading1, adjusted for hip geometry such as alpha angle) and (IIB) patient reported outcomes (as determined by HOOS15);
and Aim III) To determine the relationship between hip cartilage composition (measured by MRI T1? and T2 relaxation time, Aim I outcomes), and sagittal plane hip kinematics and kinetics during functional tasks (peak hip flexion angle and peak hip extension moments during gait, stairs, and sit-to-stand). A total of 144 hips across a range of OA severity will be included in the study. Advanced quantitative imaging, motion analysis, and functional testing will be performed annually over three years (baseline, 1, 2, and 3 year follow-up). This comprehensive evaluation of the associations of hip cartilage relaxation times, lesion prevalence, and biomechanics is the vital first step to determine the natural history of hip OA using non-invasive assessment. This information forms the crux of what is needed to design and assess the effectiveness of conservative (gait retraining, muscle strengthening), disease modifying drugs, and surgical (femoral and pelvic osteotomy, etc.) interventions at slowing or reversing the disease process.

Public Health Relevance

Hip osteoarthritis affects an estimated 27 million individuals in the United States, with an annual cost of over 185 billion dollars. This proposal will comprehensively evaluate the associations of hip cartilage health, functional biomechanics, and progression of the disease. These data are critical to design and assess the effectiveness of conservative interventions, disease modifying drugs, and surgical interventions at slowing or reversing the disease process.

Agency
National Institute of Health (NIH)
Institute
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Type
Research Project (R01)
Project #
5R01AR069006-03
Application #
9491589
Study Section
Skeletal Biology Structure and Regeneration Study Section (SBSR)
Program Officer
Zheng, Xincheng
Project Start
2016-07-14
Project End
2021-04-30
Budget Start
2018-05-01
Budget End
2019-04-30
Support Year
3
Fiscal Year
2018
Total Cost
Indirect Cost
Name
University of California San Francisco
Department
Radiation-Diagnostic/Oncology
Type
Schools of Medicine
DUNS #
094878337
City
San Francisco
State
CA
Country
United States
Zip Code
94118
Samaan, Michael A; Pedoia, Valentina; Zhang, Alan L et al. (2018) A novel mr-based method for detection of cartilage delamination in femoroacetabular impingement patients. J Orthop Res 36:971-978
Neumann, Jan; Zhang, Alan L; Schwaiger, Benedikt J et al. (2018) Validation of scoring hip osteoarthritis with MRI (SHOMRI) scores using hip arthroscopy as a standard of reference. Eur Radiol :
Grace, Trevor; Samaan, Michael A; Souza, Richard B et al. (2018) Correlation of Patient Symptoms With Labral and Articular Cartilage Damage in Femoroacetabular Impingement. Orthop J Sports Med 6:2325967118778785
Samaan, Michael A; Schwaiger, Benedikt J; Gallo, Matthew C et al. (2017) Joint Loading in the Sagittal Plane During Gait Is Associated With Hip Joint Abnormalities in Patients With Femoroacetabular Impingement. Am J Sports Med 45:810-818
Adusumilli, Gautam; Joseph, Solomon Eben; Samaan, Michael A et al. (2017) iPhone Sensors in Tracking Outcome Variables of the 30-Second Chair Stand Test and Stair Climb Test to Evaluate Disability: Cross-Sectional Pilot Study. JMIR Mhealth Uhealth 5:e166
Pedoia, Valentina; Gallo, Matthew C; Souza, Richard B et al. (2017) Longitudinal study using voxel-based relaxometry: Association between cartilage T1? and T2 and patient reported outcome changes in hip osteoarthritis. J Magn Reson Imaging 45:1523-1533
Gallo, M C; Wyatt, C; Pedoia, V et al. (2016) T1? and T2 relaxation times are associated with progression of hip osteoarthritis. Osteoarthritis Cartilage 24:1399-407
Samaan, Michael A; Zhang, Alan L; Gallo, Matthew C et al. (2016) Quantitative magnetic resonance arthrography in patients with femoroacetabular impingement. J Magn Reson Imaging 44:1539-1545