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Background: Femoroacetabular acetabular impingement syndrome (FAIS) consists of abnormal hip joint morphology resulting in painful hip joint impingement. Hip arthroscopy corrects the abnormal morphology and reduces clinical symptoms associated with FAIS yet the effects of hip arthroscopy on gait mechanics and cartilage health are not well understood. Methods:Ten FAIS patients and 10 matched healthy controls were recruited and underwent gait analysis consisting of 3D hip joint kinematics and kinetics. FAIS patients underwent gait analysis and quantitative magnetic resonance imaging of the surgical hip joint before and seven months after surgery. Patient reported outcomes (PRO) were used to quantify hip joint pain, function and quality of life and were obtained from all study participants.Findings: No significant differences were observed in hip joint kinematics or kinetics prior to surgery in the FAIS patients compared to healthy controls. After surgery, FAIS patients exhibited improved PRO, similar hip joint kinematic patterns, increased hip flexion moment impulse (HFMI) and decreased hip extension moment impulse within the surgical limb. FAIS patients that ambulated with increased HFMI after surgery demonstrated a decrease in posterior and anterior femoral T1ρ and T2 values.

Purpose To validate SHOMRI gradings in preoperative hip magnetic resonance imaging (MRI) with intra-arthroscopic evaluation of intraarticular hip abnormalities. Methods Preoperative non-arthrographic 3.0-T MRIs of 40 hips in 39 patients (1 patient with bilateral hip surgery) with femoroacetabular impingement (FAI) syndrome (mean age, 34.7 years ± 9.0; n = 16 females), refractory to conservative measures, that underwent hip arthroscopy were retrospectively assessed by two radiologists for chondrolabral abnormalities and compared with intra-arthroscopic findings as the standard of reference. Arthroscopically accessible regions were compared with the corresponding SHOMRI subregions and assessed for the presence and grade of cartilaginous pathologies in the acetabulum and femoral head. The acetabular labrum was assessed for the presence or absence of labral tears. For the statistical analysis sensitivity and specificity as well as intraclass correlation (ICC) for interobserver agreement were calculated. Results Regarding chondral abnormalities, 58.8% of the surgical cases showed chondral defects. SHOMRI scoring showed a sensitivity of 95.7% and specificity of 84.8% in detecting cartilage lesions. Moreover, all cases with fullthickness defects (n = 9) were identified correctly, and in n = 6 cases (out of n = 36 with partial-thickness defects) the defective cartilage was identified but the actual depth overestimated. Labral tears were present in all cases and the MR readers identified 92.5% correctly. ICC showed a good interobserver agreement with 86.3% (95% CI 80.0, 90.6%) Conclusion Using arthroscopic correlation, SHOMRI grading of the hip proves to be a reliable and precise method to assess chondrolabral hip joint abnormalities. Key Points • Assessment of hip abnormalities using MRI with surgical correlation.• Comparing surgery and MRI by creating a hybrid anatomic map that covers both modalities.• Non-arthrographic use of 3.0-T MRI provides detailed information on cartilage and labral abnormalities in hip joints.