Diagnostic performance of direct traction MR arthrography of the hip: detection of chondral and labral lesions with arthroscopic comparison

Schmaranzer, Florian; Klauser, Andrea; Kogler, Michael; Henninger, Benjamin; Forstner, Thomas; Reichkendler, M.; Schmaranzer, Ehrenfried

doi:10.1007/s00330-014-3534-x

Cited by 87 publications

(64 citation statements)

References 27 publications

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“…In another recent study, the sensitivity of MR arthrography was reported to be 65% [41], which is in agreement with a pooled sensitivity of 62% and specificity of 86% reported in the review by Smith et al [42]. High accuracies for the detection of chondral and labral lesions under weight-adapted traction of the hip joint were recently reported, suggesting that the diagnostic value of MR arthrography may further be improved [43].…”

Section: Mr Arthrographysupporting

confidence: 78%

Regional Articular Cartilage Abnormalities of the Hip

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Schwaiger

Zhang

2015

American Journal of Roentgenology

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Section: Mr Arthrographysupporting

confidence: 78%

Regional Articular Cartilage Abnormalities of the Hip

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Schwaiger

Zhang

2015

American Journal of Roentgenology

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“…The arthroscopy image (b), 9 days after the preoperative hip MRI, confirmed the full-thickness defect of the articular cartilage protocol for optimal visualization of the hip joint. To better differentiate the cartilage layers, Schmaranzer et al used traction MR arthrography in 73 patients who underwent arthroscopy afterwards [29]. While this technique improves the visualization of articular cartilage layers as two distinct layers, and as shown by the authors of this study, also allows an accurate detection of chondrolabral abnormalities, in the clinical setting it assumes a certain level of comfort and might carry the risk of patient discomfort and eventually development of pain.…”

Section: Discussionmentioning

confidence: 89%

Validation of scoring hip osteoarthritis with MRI (SHOMRI) scores using hip arthroscopy as a standard of reference

et al. 2018

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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.

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“…These were available for 37 of the 67 hips (55%) of the anteverting PAO group and 48 of the 57 hips (84%) of the rim trimming through surgical hip dislocation group. Lesions of the labrum and the acetabular/femoral cartilage were assessed and graded according to a previously published standardized grading system [38], which had moderate interobserver agreement for labral lesions and substantial agreement for lesions of the acetabular/femoral cartilage. There were no differences between the two groups for preoperative labral and/or acetabular/femoral cartilage lesions (Table 1).…”

Section: Methodsmentioning

confidence: 99%

Periacetabular Osteotomy Provides Higher Survivorship Than Rim Trimming for Acetabular Retroversion

Zurmühle

Anwander

Albers

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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Background Acetabular retroversion can cause impaction-type femoroacetabular impingement leading to hip pain and osteoarthritis. It can be treated by anteverting periacetabular osteotomy (PAO) or acetabular rim trimming with refixation of the labrum. There is increasing evidence that acetabular retroversion is a rotational abnormality of the entire hemipelvis and not a focal overgrowth of the anterior acetabular wall, which favors an anteverting PAO. However, it is unknown if this larger procedure would be beneficial in terms of survivorship and Merle d'Aubigné scores in a midterm followup compared with rim trimming. Questions/purposes We asked if anteverting PAO results in increased survivorship of the hip compared with rim trimming through a surgical hip dislocation in patients with symptomatic acetabular retroversion. Methods We performed a retrospective, comparative study evaluating the midterm survivorship of two matched patient groups with symptomatic acetabular retroversion undergoing either anteverting PAO or acetabular rim trimming through a surgical hip dislocation. Acetabular retroversion was defined by a concomitantly present positive crossover, posterior wall, and ischial spine sign. A total of 279 hips underwent a surgical intervention for acetabular retroversion at our center between 1997 and 2012 (166 periacetabular osteotomies, 113 rim trimmings through surgical hip dislocation). A total of 99 patients (60%) were excluded from the PAO group and 56 patients (50%) from the rim trimming group because they had any of several prespecified conditions (eg, dysplasia . A minimum followup of 2 years was required for this study. Failures were included at any time. The median followup for the anteverting PAO group was 9.5 years (range, 2-17.4 years) and 6.8 years (range, 2.2-10.5 years) for the rim trimming group (p \ 0.001). Kaplan-Meier survivorship analysis was performed using the following endpoints at 5 and 10 years: THA, radiographic One author (MT) has received funding from the Swiss National Science Foundation (SNSF). All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research 1 editors and board members are on file with the publication and can be viewed on request. Each author certifies that his or her institution has approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

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Diagnostic performance of direct traction MR arthrography of the hip: detection of chondral and labral lesions with arthroscopic comparison

Abstract: • The used traction technique was well tolerated by most patients. • The used traction technique almost consistently achieved separation of cartilage layers. • Traction MR arthrography enabled accurate detection of chondral and labral lesions.

Cited by 87 publications

References 27 publications

Regional Articular Cartilage Abnormalities of the Hip

Regional Articular Cartilage Abnormalities of the Hip

Validation of scoring hip osteoarthritis with MRI (SHOMRI) scores using hip arthroscopy as a standard of reference

Periacetabular Osteotomy Provides Higher Survivorship Than Rim Trimming for Acetabular Retroversion

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