Preoperative Magnetic Resonance Imaging Predicts Intraoperative Labral Width at the 9-O’clock and 12-O’clock Positions in Primary Hip Arthroscopy

Abstract

PurposeTo determine whether preoperative magnetic resonance imaging (MRI) can reliably predict labral width in primary hip arthroscopy.MethodsPatients who underwent primary hip arthroscopy with labral repair performed by a single surgeon from January 2008 to December 2015 were identified retrospectively from a prospectively collected database. The width of the labrum was measured intraoperatively at the time of surgery. Two orthopaedic surgeons performed labral width measurements on MRI at 3 standardized locations using the clock-face method at 2 time points, 4 weeks apart. Interobserver and intraobserver reliabilities were calculated, and comparisons were performed between intraoperatively measured labral widths and MRI measurements at the 3 positions.ResultsFifty-eight patients who underwent primary hip arthroscopy were enrolled in the study. The average labral width measurements at the 3-, 12-, and 9-o’clock positions were 6.8 mm (standard deviation [SD], 1.1), 6.9 mm (SD, 1.3 mm), and 6.2 mm (SD, 0.9 mm), respectively, on MRI compared with 7.2 mm (SD, 1.5 mm), 7.8 mm (SD, 2.3 mm), and 7.3 mm (SD, 1.6 mm), respectively, when measured intraoperatively. The intraoperative measurements were larger than the MRI measurements at all 3 locations, with significant differences at the 12-o’clock (P = .008) and 9-o’clock (P < .001) positions. The positive predictive value of the MRI measurements was 92% at the 3-o’clock position, 89% at the 12-o’clock position, and 94% at the 9-o’clock position for identifying a labral width of 6 mm or greater.ConclusionsMeasuring labral width on MRI yielded, on average, a value that is smaller than the intraoperatively measured width in primary hip arthroscopy procedures. MRI can predict a labral width of 6 mm or greater in at least 89% of cases, which will assist in operative planning.Clinical RelevanceThe clinical implications of this research include identifying the rare patients in whom more advanced hip arthroscopy procedures may be indicated, such as labral augmentation, in instances of inadequate labral volume that will adequately restore the biomechanics of the suction seal.