Pre-Operative MRA Accurately Predicts Capsulolabral Adhesions at Revision Hip Arthroscopy

Steven M Leary; Catherina Zadeh; Mustafa Hashimi; Nastaran Fatemi; Garrett V Christensen; Joseph M Rund; Courtney Seffker; Michael C Willey; Robert W Westermann

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Pre-Operative MRA Accurately Predicts Capsulolabral Adhesions at Revision Hip Arthroscopy

Journal article

Open access

Peer reviewed

Pre-Operative MRA Accurately Predicts Capsulolabral Adhesions at Revision Hip Arthroscopy

Steven M Leary, Catherina Zadeh, Mustafa Hashimi, Nastaran Fatemi, Garrett V Christensen, Joseph M Rund, Courtney Seffker, Michael C Willey and Robert W Westermann

The Iowa orthopaedic journal, Vol.45(1), pp.187-192

2025

PMCID: PMC12212340

PMID: 40606730

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https://pmc.ncbi.nlm.nih.gov/articles/PMC12212340/View

Published (Version of record) Open Access

Abstract

To determine the accuracy of preoperative magnetic resonance arthrogram (MRA) in detecting capsulolabral adhesions in patients undergoing revision hip arthroscopy. We retrospectively reviewed revision hip arthroscopies performed by a single surgeon between 2019 and 2022. Patients without preoperative MRA were excluded. Musculoskeletal radiologists blinded to surgical variables assessed pre-operative axial T1 FS MRA for adhesions and graded adhesions as mild (length <5 mm), moderate (5-10 mm), or severe (> 10mm). Paralabral sulcus effacement increased the grade one level beyond adhesion length. Intraoperative arthroscopy images were evaluated for the incidence and severity of adhesions. Adhesions were graded intraoperatively as mild (rare, small adhesions), moderate (multiple or large adhesions), or severe (many adhesions disrupting labral function). A grade of 0 was assigned if no adhesions were present. Graders were blinded to each other, and Wilcoxon signed-rank test compared diagnosis methods. Sensitivity, specificity, and predictive values (PPV, NPV) were also calculated. We identified 42 patients, 45 hips with pre-operative MRA undergoing revision hip arthroscopy. On MRA grading, there were 41 patients with adhesions (93%), of which 14 were considered severe (33%), 22 moderate (52%), and 6 mild (14%). On intraoperative grading (ICC 0.73, Kappa 0.35), there were 32 cases (71%) with 14 considered severe (31%), 10 moderate (22%), and 8 mild (18%). There was no difference in severity assessment between pre-operative MRA and intraoperative findings (P<0.001). Pre-operative MRA was moderately able to predict intra-operative adhesions (sensitivity 90.6%, PPV 69%). Specificity could not be calculated. Axial T1 FS MRA is a sensitive tool to assess for capsulolabral adhesions in the revision arthroscopy setting. MRA best predicts severe adhesions and is moderately predictive of mild and moderate adhesions. .

Adult

Aged

Arthroplasty, Replacement, Hip - adverse effects

Arthroscopy - methods

Female

Hip Joint - diagnostic imaging

Hip Joint - surgery

Humans

Magnetic Resonance Imaging - methods

Male

Middle Aged

Predictive Value of Tests

Preoperative Care - methods

Reoperation

Retrospective Studies

Tissue Adhesions - diagnostic imaging

Details

Title: Subtitle: Pre-Operative MRA Accurately Predicts Capsulolabral Adhesions at Revision Hip Arthroscopy
Creators: Steven M Leary - University of Iowa
Catherina Zadeh - University of Iowa
Mustafa Hashimi - University of Iowa
Nastaran Fatemi - University of Iowa
Garrett V Christensen - University of Iowa
Joseph M Rund - University of Iowa
Courtney Seffker - University of Iowa Hospitals and Clinics
Michael C Willey - University of Iowa
Robert W Westermann - University of Iowa
Resource Type: Journal article
Publication Details: The Iowa orthopaedic journal, Vol.45(1), pp.187-192
PMID: 40606730
PMCID: PMC12212340
NLM abbreviation: Iowa Orthop J
ISSN: 1555-1377
eISSN: 1555-1377
Language: English
Date published: 2025
Academic Unit: Radiology; Orthopedics and Rehabilitation; Injury Prevention Research Center; Athletic Training Program
Record Identifier: 9984843243402771

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