MR study of longitudinal variations in proximal femur 3D morphological shape and associations with cartilage health in hip osteoarthritis

The goal of this study was to use quantitative MRI analysis to longitudinally observe the relationship between 3D proximal femur shape and hip joint degenerative changes. Forty‐six subjects underwent unilateral hip MR imaging at three time points (baseline, 18 and 36 months). 3D shape analysis, hip cartilage T_1ρ/T₂ relaxation time quantification, and SHOMRI MRI grading were performed at each time point. Subjects were grouped based on KL, SHOMRI, and HOOS pain scores. Associations between these score groupings, time, and longitudinal variation in shape, were analyzed using a generalized estimating equation. One‐way ANCOVA was conducted to evaluate change in shape as a predictor of the worsening of degenerative changes at 36 months. Our results demonstrated that subjects displayed an increase in the volume of the femoral head and neck (Mode 3) over time. This shape mode was significantly more prevalent in patients that reported pain. Longitudinal changes in this shape mode also served as borderline predictors of elevated T_1ρ values (p = 0.055) and of cartilage lesions (p = 0.068). Subjects showed a change in the Femoral Neck Anteversion angle (FNA) over time (Mode 6). This shape mode showed a significant interaction with the presence of cartilage lesions. The results of this study suggest that specific variations in bone shape quantified through 3D‐MRI based Statistical Shape modeling show an observable relationship with hip joint compositional and morphological changes. The shapes observed lead to early degenerative changes, which may lead into OA, thus confirming the important role of bone shape changes in the pathogenesis of OA.