Purpose
Numbers of hip arthroscopies for FAI correction have risen exponentially,
leading to an increase of patients with persistent pain who undergo postoperative MR imaging.
However to date the spectrum of imaging findings comparing pre- and postoperative imaging has to date not been comprehensively studies.
Thus,
we aimed to assess the prevalence of new/residual (1) osseous deformities,
(2) intra-articular lesions and (3) progression of osteoarthritis in symptomatic patients undergoing pre- and postoperative MR imaging after hip arthroscopy.
Methods and Materials
IRB-approved,
retrospective study.
Between 2010-17,
806 patients underwent arthroscopic FAI correction and/or labrum surgery.
Database was reviewed for symptomatic patients with complete radiographs and traction MR arthrography (MRA) of the hip (1.5 T) obtained before and after hip arthroscopy according to the routine protocol.
49 patients were included: mean age 29 ± 10 years,
67% female.
Traction was applied using a MR-compatible traction device with weight-adaption Fig. 1 .
One reader assessed pre- and postoperative images.
(1) Acetabular coverage (LCE<25° = dysplasia,
LCE>39° = pincer...
Results
Preoperatively 42 (86%) hips showed deformities: 2 (4%) dysplastic-,
11 (22%) pincer- and 39 (80%) cam deformities.
Postoperatively 39 (80%) hips showed deformities; 9 (18%) dysplastic-,
8 (16%) pincer-,
20 (41%) cam deformity,
4 (8%) hips with torsion <5°,
10 (20%) hips with torsion >30° Fig. 2 .
Postoperatively 14 (29%) cases with residual-,
12 (24%) cases with labrum retears were observed.
6 (12%) hips had capsular adhesions,
22 (45%) had capsular defects Fig. 2 .
Radiographic OA progression was observed in 5 (10%) hips,...
Conclusion
Prevalence of osseous deformities due to over- or undercorrection and intra-articular lesions is high after failed hip arthroscopy.
Traction MRA was useful for detection of OA progression.
Identification of osseous over-/undercorrection after failed hip arthroscopy is essential because open surgical approaches must be considered for correction of dysplasia and abnormal femoral torsion.