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Clinical Orthopaedics and Related Research®

, Volume 470, Issue 7, pp 1950–1957 | Cite as

Preoperative Three-dimensional CT Predicts Intraoperative Findings in Hip Arthroscopy

  • Benton E. Heyworth
  • Mark M. Dolan
  • Joseph T. Nguyen
  • Neal C. Chen
  • Bryan T. Kelly
Clinical Research

Abstract

Background

Currently, plain radiographs and MRI are the standard imaging modalities used for diagnosing femoroacetabular impingement (FAI) and preoperative planning for arthroscopic treatment of FAI. The value of three-dimensional (3D) CT for these purposes is unclear.

Questions/purposes

We therefore determined the reliability of CT assessment of FAI and whether CT findings of hip disease predict arthroscopic findings.

Methods

We retrospectively assessed the preoperative CT scans of 118 patients who underwent primary hip arthroscopy. Intraoperative findings, including size of the cam lesion, presence of an acetabular labral articular disruption lesion, and one of four types of labral tear were recorded and compared with the retrospectively read CT findings.

Results

Agreement analysis between CT and intraoperative detection of FAI yielded kappa values of 0.48 for cam lesions and 0.16 for pincer lesions. Increasing values for the CT-based alpha angle correlated with increasing severity of arthroscopically assessed acetabular labral articular disruption grade. Each pattern of FAI predicted a specific labral tear type.

Conclusions

Our data suggest CT has moderate value in predicting mechanically based labral tear patterns, although better parameters for assessment of pincer lesions are needed. Diagnostic assessment of patients with suspected FAI may be improved with use of 3D CT.

Level of Evidence

Level III, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence.

Keywords

Alpha Angle Labral Tear Acetabular Cartilage Labral Lesion Acetabular Version 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

We thank Steven Albert MD, Douglas Decorato MD, Robert Ludwig MD, and Gavin L. Duke MD for assistance in evaluating CT scans for this study.

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Copyright information

© The Association of Bone and Joint Surgeons® 2012

Authors and Affiliations

  • Benton E. Heyworth
    • 1
  • Mark M. Dolan
    • 2
  • Joseph T. Nguyen
    • 3
  • Neal C. Chen
    • 4
  • Bryan T. Kelly
    • 5
  1. 1.Children’s Hospital BostonHarvard Medical SchoolBostonUSA
  2. 2.Department of Orthopaedic Surgery, Northwestern Memorial HospitalNorthwestern University Feinberg School of MedicineChicagoUSA
  3. 3.Department of BiostatisticsHospital for Special SurgeryNew YorkUSA
  4. 4.Philadelphia Hand CenterPhiladelphiaUSA
  5. 5.Department of Orthopaedic SurgeryHospital for Special Surgery, Weill Cornell School of MedicineNew YorkUSA

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