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Anterior Impingement Test for Labral Lesions Has High Positive Predictive Value

  • Clinical Research
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

The anterior impingement test is intended to detect anterosuperior acetabular labral lesions. In patients treated for labral lesions its sensitivity is reportedly 95% to 100%, and in a small group of patients undergoing periacetabular osteotomy, its sensitivity was 59% and specificity 100%. However, the sensitivity, specificity, positive predictive value, and negative predict value of this test to detect these labral lesions in unselected patients with hip pain are unknown.

Questions/purposes

We investigated these four parameters (1) in unselected patients with hip pain, and (2) in three subgroups of patients with dysplasia, femoroacetabular impingement (FAI), and with an intact joint space.

Methods

We prospectively studied 69 patients (15 men and 54 women) with a mean age of 57.2 years (range, 27–81 years). One observer performed the anterior impingement test in all patients. We determined the presence or absence of an anterosuperior labral lesion with radial MRI in 107 hips (38 patients in both hips: 14 with pain, and 24 without pain). We also investigated the parameters in the three subgroups which consisted of 60 cases of dysplasia, 27 cases of FAI, and 80 cases with intact joint space; the third subgroup partially overlapped the first and second subgroups.

Results

The four parameters in all hips were 50.6% (45/89), 88.9% (16/18), 95.7% (45/47), and 26.7% (16/60), respectively. Parameters in the three subgroups were similar to those of all cases.

Conclusions

Although the sensitivity of the anterior impingement test did not reach a sufficient level for detecting anterosuperior labral lesions, we believe the high positive predictive value makes the test useful.

Level of Evidence

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

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Kansai Rosai Hospital, 1-69, Inabasou 3 Chome, Amagasaki, Hyogo, 660-8511, Japan

    Takehito Hananouchi MD, PhD, Yukihiko Yasui MD, Kengo Yamamoto MD, Yukiyoshi Toritsuka MD, PhD & Kenji Ohzono MD, PhD

Authors
  1. Takehito Hananouchi MD, PhD
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  2. Yukihiko Yasui MD
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  3. Kengo Yamamoto MD
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  4. Yukiyoshi Toritsuka MD, PhD
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  5. Kenji Ohzono MD, PhD
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Corresponding author

Correspondence to Takehito Hananouchi MD, PhD.

Additional information

One of the authors (TH) received funding from the Japan Labour Health and Welfare Organization.

Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.

Each author certifies that his institution has approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

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Hananouchi, T., Yasui, Y., Yamamoto, K. et al. Anterior Impingement Test for Labral Lesions Has High Positive Predictive Value. Clin Orthop Relat Res 470, 3524–3529 (2012). https://doi.org/10.1007/s11999-012-2450-0

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  • DOI: https://doi.org/10.1007/s11999-012-2450-0

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