Are degenerative findings detected on traction MR arthrography of the hip associated with failure of arthroscopic femoroacetabular impingement surgery?

Lerch, Till D; Nanavati, Andreas K; Heimann, Alexander F; Meier, Malin K; Steppacher, Simon D; Wagner, Moritz; Brunner, Alexander; Vavron, Peter; Schmaranzer, Ehrenfried; Schwab, Joseph M; Tannast, Moritz; Schmaranzer, Florian (2024). Are degenerative findings detected on traction MR arthrography of the hip associated with failure of arthroscopic femoroacetabular impingement surgery? European radiology, 34(6), pp. 3555-3565. Springer-Verlag 10.1007/s00330-023-10419-3

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OBJECTIVES

To identify preoperative degenerative features on traction MR arthrography associated with failure after arthroscopic femoroacetabular impingement (FAI) surgery.

METHODS

Retrospective study including 102 patients (107 hips) undergoing traction magnetic resonance arthrography (MRA) of the hip at 1.5 T and subsequent hip arthroscopic FAI surgery performed (01/2016 to 02/2020) with complete follow-up. Clinical outcomes were assessed using the International Hip Outcome Tool (iHOT-12) score. Clinical endpoint for failure was defined as an iHOT-12 of < 60 points or conversion to total hip arthroplasty. MR images were assessed by two radiologists for presence of 9 degenerative lesions including osseous, chondrolabral/ligamentum teres lesions. Uni- and multivariate Cox regression analysis was performed to assess the association between MRI findings and failure of FAI surgery.

RESULTS

Of the 107 hips, 27 hips (25%) met at least one endpoint at a mean 3.7 ± 0.9 years follow-up. Osteophytic changes of femur or acetabulum (hazard ratio [HR] 2.5-5.0), acetabular cysts (HR 3.4) and extensive cartilage (HR 5.1) and labral damage (HR 5.5) > 2 h on the clockface were univariate risk factors (all p < 0.05) for failure. Three risk factors for failure were identified in multivariate analysis: Acetabular cartilage damage > 2 h on the clockface (HR 3.2, p = 0.01), central femoral osteophyte (HR 3.1, p = 0.02), and femoral cartilage damage with ligamentum teres damage (HR 3.0, p = 0.04).

CONCLUSION

Joint damage detected by preoperative traction MRA is associated with failure 4 years following arthroscopic FAI surgery and yields promise in preoperative risk stratification.

CLINICAL RELEVANCE STATEMENT

Evaluation of negative predictors on preoperative traction MR arthrography holds the potential to improve risk stratification based on the already present joint degeneration ahead of FAI surgery.

KEY POINTS

• Osteophytes, acetabular cysts, and extensive chondrolabral damage are risk factors for failure of FAI surgery. • Extensive acetabular cartilage damage, central femoral osteophytes, and combined femoral cartilage and ligamentum teres damage represent independent negative predictors. • Survival rates following hip arthroscopy progressively decrease with increasing prevalence of these three degenerative findings.

Item Type:

Journal Article (Original Article)

Division/Institute:

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

UniBE Contributor:

Lerch, Till, Nanavati, Andreas Kavin, Meier, Malin Kristin, Steppacher, Simon Damian, Schmaranzer, Florian

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0938-7994

Publisher:

Springer-Verlag

Language:

English

Submitter:

Pubmed Import

Date Deposited:

21 Nov 2023 09:43

Last Modified:

12 Jun 2024 00:12

Publisher DOI:

10.1007/s00330-023-10419-3

PubMed ID:

37982837

Uncontrolled Keywords:

Hip Hip arthroscopy Labrum MR arthrography MRI

BORIS DOI:

10.48350/189214

URI:

https://boris.unibe.ch/id/eprint/189214

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