History, examination, and concordant radiographs critical for the management of young patients with FAI


Ramkumar PN, et al. Paper 45. Offered at: American Orthopedic Society for Sports activities Drugs; July 13-17, 2022; Colorado Springs, Colorado

Disclosures: Ramkumar doesn’t report related monetary disclosures.

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COLORADO SPRINGS, Colo. — MRI earlier than main hip arthroscopy is probably not as helpful clinically as concordant historical past, bodily examination, and radiographs alone amongst younger sufferers with femoroacetabular impingement, based on examine information.

“The surgeon’s historical past, examination, and radiographic analysis have been adequate to diagnose this [FAI] and point out younger main sufferers for hip arthroscopy,” Prem N. Ramkumar, MD, MBA, he stated on the annual assembly of the American Orthopedic Society for Sports activities Drugs.

Within the retrospective examine, Ramkumar and colleagues reviewed 1,391 sufferers aged 40 years and youthful who have been indicated and underwent main hip arthroscopy for femoroacetabular impingement (FAI) between August 2015 and December 2020. The researchers excluded these sufferers who had a earlier MRI, contraindications to MRI, reattempt conservative therapy, or sufferers with concomitant periacetabular osteotomy. General, the researchers studied 322 sufferers who introduced with no preoperative MRI and in the end underwent an MRI earlier than hip arthroscopy and 1,069 sufferers who introduced with a preoperative MRI. There have been no demographic variations between teams, with 63% of all sufferers having a imply BMI of 25.6 kg/mtwo and imply age of 25.8 years. The surgeons got here from 4 completely different facilities, Ramkumar stated.

Prem N. Ramkumar

Prem N. Ramkumar

The researchers in contrast preoperative MRI with workplace analysis, which consisted of concordant historical past and bodily examination, plain radiographs, and intraoperative findings discovered throughout hip arthroscopy. They recorded the time from the preliminary analysis to the MRI and the time from the MRI to the hip arthroscopy.

They discovered 198 sufferers with MRI findings of anterosuperior labral tears, which have been additionally revealed and repaired throughout hip arthroscopy. Three sufferers had questionable articular cartilage pathology seen on preoperative MRI, however none required surgical therapy or reoperation. No affected person underwent main labral reconstruction.

“Preoperative MRI didn’t alter the choice to function or the precise surgical plan for the 322 sufferers indicated with out an MRI. For this group, this wasted about 3 weeks of those sufferers’ life time,” stated Ramkumar.

He stated that though referrals to the hip arthroscopist with an MRI saved a month, this examine didn’t observe sufferers who by no means had surgical procedure or who had a analysis aside from FAI.

“The underside line is that hip MRI must be left to the discretion of the surgeon,” he stated.

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