Postoperative Traction MR Arthrography in Patients with Persisting Pain after Arthroscopic FAI Correction Reveals High Prevalence of Osseous Deformities and Intra-Articular Lesions

Schmaranzer, Florian; Lerch, Till; Siebenrock, Klaus; Schmaranzer, Ehrenfried; Tannast, Moritz (2020). Postoperative Traction MR Arthrography in Patients with Persisting Pain after Arthroscopic FAI Correction Reveals High Prevalence of Osseous Deformities and Intra-Articular Lesions. Seminars in musculoskeletal radiology, 24(S01), S1-S8. Thieme Medical Publishers 10.1055/s-0040-1709557

Introduction Patient management after failed arthroscopic femoroacetabular impingement (FAI) surgery is challenging. We assessed the prevalence of new/residual osseous deformities, intra-articular lesions, and progression of osteoarthritis (OA) in symptomatic patients undergoing pre- and postoperative magnetic resonance (MR) imaging after hip arthroscopy. Material and Methods We conducted a retrospective study approved by the institutional review board. Between 2010 and 2017, 17,806 patients underwent arthroscopic FAI correction. The database was reviewed for symptomatic patients with traction magnetic resonance arthrography (MRA) of the hip obtained before and after hip arthroscopy. A total of 49 patients was included (29 ± 10 years of age and 67% female). Traction was applied using a MR-compatible traction device. One reader assessed pre- and postoperative images for (1) acetabular coverage (lateral center edge < 25 degrees/> 39 degrees: dysplasia/pincer) and Tönnis OA grade on anteroposterior pelvic views; cam deformity (radial images α > 60 degrees); femoral torsion: low/high torsion: < 5 degrees/> 30 degrees; (2) residual tears and re-tears of the labrum and capsular adhesions/defects; and (3) OA progression on MRI. Results Preoperatively, 42 (86%) hips showed deformities (some patients presented several different deformities; numbers do not add up): 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 degrees, and 10 (20%) hips with torsion > 30 degrees. Postoperatively, 14 (29%) cases with residual and 12 (24%) cases with labrum re-tears were observed. Six (12%) hips had capsular adhesions; 22 (45%) had capsular defects. Radiographic OA progression was observed in 5 (10%) hips and in 14 (30%) hips on traction MRA. Conclusion Prevalence of osseous deformities due to over- or undercorrection and intra-articular lesions is high after failed hip arthroscopy. Traction MRA was useful to detect OA progression.

Item Type:

Conference or Workshop Item (Abstract)

Division/Institute:

04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Orthopaedic Surgery
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology

UniBE Contributor:

Schmaranzer, Florian; Lerch, Till; Siebenrock, Klaus-Arno and Tannast, Moritz

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1089-7860

Publisher:

Thieme Medical Publishers

Language:

English

Submitter:

Maria de Fatima Henriques Bernardo

Date Deposited:

13 May 2020 08:03

Last Modified:

13 May 2020 08:06

Publisher DOI:

10.1055/s-0040-1709557

Related URLs:

Additional Information:

Speech and ePoster

URI:

https://boris.unibe.ch/id/eprint/143484

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