What MRI Findings Predict Failure 10 Years After Surgery for Femoroacetabular Impingement?

Hanke, Markus S.; Steppacher, Simon D.; Anwander, Helen; Werlen, Stefan; Siebenrock, Klaus A.; Tannast, Moritz

doi:10.1007/s11999-016-5040-8

Cited by 58 publications

(49 citation statements)

References 70 publications

(90 reference statements)

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“…Although the role of cartilage repair procedures is yet to be defined, preoperative MR imaging should enable accurate visualization of direct or indirect signs of cartilage damage. [53][54][55] This is of crucial importance because the long-term success of any joint-preserving surgery depends on the severity of the already present cartilage damage. [56][57][58]…”

Section: Mr Arthrography Of the Hip Joint Indicationsmentioning

confidence: 99%

“…[110][111][112] In light of these conflicting reports, it is important to highlight that extensive cartilage damage (> 2 hours on the clock face, i.e., extending over 60 degrees on the radial plane) was identified as the strongest risk factor for long-term failure of FAI correction based on preoperative direct MR arthrography at 1.5 T that supports its prognostic value. 53 Further advantages of direct MR arthrography include the possibility to perform a simultaneous intra-articular test infiltration with local anesthetics and to apply axial leg traction 96 and to move on to CT arthrography in case of an uncooperative patient.…”

Section: Mri Protocolmentioning

confidence: 99%

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Conventional and Arthrographic Magnetic Resonance Techniques for Hip Evaluation: What the Radiologist Should Know

Schmaranzer

Cerezal

Llopis

2019

Semin Musculoskelet Radiol

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Over the last 2 decades, the definition of pathomechanical concepts that link osseous deformities to chondrolabral damage and expose young and active patients to the risk of early osteoarthritis has led to a tremendous increase in the number of joint-preserving surgeries performed. The rise in arthroscopic procedures has led to an increasing demand for comprehensive preoperative magnetic resonance imaging (MRI) assessment of the hip joint. This includes conventional MRI for the assessment of extra-articular and periarticular pathologies such as greater trochanteric pain, deep gluteal pain syndrome, and sports injuries. Magnetic resonance arthrography with or without traction is reserved for the accurate evaluation of deformities associated with impingement and hip instability and for detecting the resulting intra-articular lesions. This article summarizes the current standard imaging techniques that the radiologist should know. It also explores the potential of computer-assisted analysis of three-dimensional MRI for virtual impingement simulation and volumetric analysis of cartilage composition and geometry.

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Section: Mr Arthrography Of the Hip Joint Indicationsmentioning

confidence: 99%

Section: Mri Protocolmentioning

confidence: 99%

Conventional and Arthrographic Magnetic Resonance Techniques for Hip Evaluation: What the Radiologist Should Know

Schmaranzer

Cerezal

Llopis

2019

Semin Musculoskelet Radiol

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“…There has been limited analysis of the preoperative MRI findings associated with failure of hip arthroscopic surgery. Hanke et al . retrospectively reviewed the preoperative MRA findings in 62 hips and found central acetabular osteophytes, extensive cartilage damage (>60° of the circumference of the acetabulum) and the presence of acetabular rim bone cysts were associated with poor outcomes 10 years after surgery for FAI.…”

Section: Factors Associated With Persistent or Recurrent Symptomsmentioning

confidence: 99%

Persistent or recurrent symptoms after arthroscopic surgery for femoroacetabular impingement: A review of imaging findings

Woodward

Philippon

2018

J Med Imag Rad Onc

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Hip arthroscopy is one of the most rapidly growing and evolving orthopaedic subspecialties. With the recent dramatic increase in the volume of hip arthroscopy performed there has been an increase in the number of symptomatic patients following arthroscopy for femoroacetabular impingement. Imaging has a key role in determining the need for revision surgery and in preoperative planning. Although the revision rate for hip arthroscopy is 3-9%, little has been published about the imaging findings associated with unsatisfactory treatment outcomes. This review discusses the significance of pre-existing osteoarthritis and underlying hip dysplasia and describes the causes of persistent symptoms. Recent literature on extra articular impingement and causes of microinstability are presented. Post-operative appearances are described focussing on the clinically relevant imaging findings. The challenges of evaluating the labrum after repair and specific findings associated with anchor failure and iatrogenic chondrolabral injury are discussed. The purpose of this article is to review the causes of unsatisfactory treatment outcomes after hip arthroscopy, role of imaging and indications for revision arthroscopy.

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“…38,69 Direct MRA of the hip is the current imaging gold standard for preoperative cartilage assessment. It has shown a higher diagnostic accuracy than noncontrast MRI in detection of acetabular cartilage lesions at 1.5 T and 3 T. 46,47 Hanke et al 70 recently presented the first data on the prognostic value of subtle degenerative changes detected on direct MRAs. On 2D radial PD-weighted images, full-thickness cartilage defects that extend over 2 hours (hazard ratio: 4.6) on the clock face and acetabular rim cysts (hazard ratio: 4.1) were identified as risk factors for failure 10 years after FAI surgery.…”

Section: Mr Imaging Techniques For Assessment Of Cartilage Lesionsmentioning

confidence: 99%

“…On 2D radial PD-weighted images, full-thickness cartilage defects that extend over 2 hours (hazard ratio: 4.6) on the clock face and acetabular rim cysts (hazard ratio: 4.1) were identified as risk factors for failure 10 years after FAI surgery. 70 Regardless of that, numerous studies reported only moderate diagnostic accuracy of direct MRA in detecting acetabular cartilage lesions in FAI at 1.5 T and 3 T. 46,71,72 More specifically, subchondral contrast accumulation that indicates cartilage delamination is a highly specific but rare finding. 71 Due to the negative atmospheric pressure maintained by the sealing function of the labrum and the tight coaptation of the opposed femoroacetabular cartilage layers, the contrast agent in direct MRAs only distends the joint capsule but usually does not enter the central compartment of the hip.…”

Section: Mr Imaging Techniques For Assessment Of Cartilage Lesionsmentioning

confidence: 99%

Intra-articular Lesions: Imaging and Surgical Correlation

Schmaranzer

Todorski

Lerch

et al. 2017

Semin Musculoskelet Radiol

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The past 2 decades have seen a substantial increase in hip joint preserving procedures, primarily secondary to not only hip dysplasia, but the recognition and description of femoroacetabular impingement (FAI), and its association with chondral lesions, as a potentially pre-arthritic condition. Morphological magnetic resonance imaging (MRI) plays an essential role in the preoperative assessment of osseous deformities and in particular of the resulting joint degeneration. An accurate descriptive report of chondrolabral lesions is warranted describing the tear pattern, size, localization, and extension of the lesions. This is important because different damage patterns and localization of the lesions may determine the surgical approach. The current imaging standard is direct magnetic resonance arthrography (MRA) with a small field of view, with acquisition of radial images in addition to the classic coronal, sagittal, and axial-oblique images. Early cartilage damage detected on direct MRA obtained with or without traction can predict long-term failure after FAI surgery.

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What MRI Findings Predict Failure 10 Years After Surgery for Femoroacetabular Impingement?

Abstract: Level III, therapeutic study.

Cited by 58 publications

References 70 publications

Conventional and Arthrographic Magnetic Resonance Techniques for Hip Evaluation: What the Radiologist Should Know

Conventional and Arthrographic Magnetic Resonance Techniques for Hip Evaluation: What the Radiologist Should Know

Persistent or recurrent symptoms after arthroscopic surgery for femoroacetabular impingement: A review of imaging findings

Intra-articular Lesions: Imaging and Surgical Correlation

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