Cam-type femoroacetabular impingement—correlations between alpha angle versus volumetric measurements and surgical findings
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Determine correlations of 3DCT cam-type femoroacetabular impingement (FAI) measurements with surgical findings of labral tear and cartilage loss.
Digital search of symptomatic cam-type FAI from July 2013 to August 2016 yielded 43 patients. Two readers calculated volumes of femoral head, bump, and alpha angles on 3DCT images. Correlations between CT and surgical findings, inter-, and intra-reader reliabilities were assessed using Spearman rank correlation and intraclass correlation coefficients (ICC).
Thirteen men and 14 women aged 37 ± 10 (mean ± SD) years were included. Most common clinical finding was positive flexion–adduction–internal rotation (70.4%). Twenty-seven labral tears and 20 cartilage defects were surgically detected. Significant correlations existed between femoral bump, head volumes, and extent of the labral tear (p = 0.008 and 0.003). No significant correlations were found between the alpha angles at 12 to 3 o’clock and the extent of labral tear (p = 0.2, 0.8, 0.9, and 0.09) or any measurement with the cartilage loss (p values for alpha 12 to 3, bump, and head volumes = 0.7, 0.3, 0.9, 0.9, 0.07, and 0.2). Inter- and intra-reader reliabilities were excellent to moderate for femoral head and bump volumes (ICC = 0.85, 0.52, and 0.8, 0.5) and moderate to poor for alpha angles (ICC = 0.48, 0.40, 0.05, 0.25 and 0.3, 0.24, 0.29, 0.49).
Three dimensional volumetric measurements of cam-type FAI significantly correlate with the extent of intraoperative labral tears. Superior inter- and intra-reader reliability to that of alpha angles renders it a more clinically relevant measurement for quantifying cam morphology.
• The 3DCT bump volume and femoral head volume showed significant correlations with the extent of labral tear (p values = 0.008 and 0.003).
• No significant correlations were seen between alpha angles and the extent of labral tear (p values > 0.05).
• Inter- and intra-reader reliability was excellent to moderate (ICC = 0.85 and 0.52, 0.8, and 0.5) for femoral head and bump volumes while inter- and intra-reader reliability was fair to poor (ICC = 0.48, 0.40, 0.05, 0.25 and 0.3, 0.24, 0.29, 0.49) for alpha angles.
KeywordsHip joint Femoroacetabular impingement Image processing Computer-assisted Tomography
Three-dimensional computed tomography
The authors state that this work has not received any funding.
Compliance with ethical standards
The scientific guarantor of this publication is Avneesh Chhabra, MD.
Conflict of interest
The authors of this manuscript declare relationships with the following companies:
RD, LZ, AG, RC, YC, NPF: no conflicts of interest.
AC: consultant ICON Medical, royalties: Jaypee, Wolters (not related).
Statistics and biometry
One of the authors has significant statistical expertise.
Written informed consent was waived by the Institutional Review Board.
Institutional Review Board approval was obtained.
• cross-sectional study
• performed at one institution
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