Postoperative Imaging in Femoroacetabular Impingement

Abstract

Femoroacetabular impingement (FAI) has been recognized as a common cause of pain, limited range of motion, and development of early osteoarthritis of the hip in adolescents and adults. Current surgical approaches include femoral osteochondroplasty, acetabular rim resection, and reattachment of torn labrum as either open surgical or arthroscopic techniques as well as periacetabular osteotomy. Conventional radiographs are routinely obtained in the postoperative setting. In addition, MRI serves for work-up in patients with persistent or recurrent groin pain after surgery. Inappropriate correction of the underlying femoral or acetabular osseous abnormality, insufficiency fractures of the femoral neck due to bone resection, intra-articular adhesions, ongoing joint degeneration including advanced cartilage damage, iatrogenic cartilage injury, retear of the labrum, rarely avascular necrosis of the femoral head, defects of the hip joint capsule, or heterotopic ossification might be observed after surgery for FAI.

Postarthroscopy Imaging in Femoroacetabular Impingement: Persistent Pain May Be Due to an Insufficient Correction of Preoperative Abnormalities

“…There is an increasing evidence that an insufficient correction of femoral and acetabular bony abnormalities is a cause of persistent groin pain and poor postoperative outcomes. 7 9 11 15 16 On the other hand, an excessive correction of these deformities may lead to femoral neck fracture and hip instability. 40 41 In patients in whom the correction of the α angle to less than 55 degrees would lead to excessive resection, limiting reduction by no more than 20 degrees should be considered.…”

“… 7 8 9 Although several criteria have been proposed in the preoperative setting, 4 the postsurgical imaging of FAI has been sporadically discussed in the literature. 9 10 11 12 13 14 15 16 …”

Femoroasetabular sıkışmada MR görüntüleme ve MR artrogram

“…Yetersiz cerrahi, kemik rezeksiyona bağlı femur boynunda görülen yetmezlik fraktürü, intraartiküler adhezyonlar, kıkırdak hasarı ve buna bağlı dejenerasyon, tekrarlayan labrum yırtıkları, iyatrojenik kıkırdak hasarı, femur başının avasküler nekrozu, eklem kapsülün-deki defektler ve heterotopik ossifikasyon, cerrahi sonrası süreçte MRG ile saptanabilir (Şekil 19 ve 20). [23] …”