Acta chirurgiae orthopaedicae
et traumatologiae Čechoslovaca

Acta Chir Orthop Traumatol Cech. 2017; 84(5):372-379 | DOI: 10.55095/achot2017/056

Korelace artroskopického a MR nálezu u sportovně aktivních pacientů s klinicky suspektní lézí acetabulárního labra - výsledky prospektivní studiePůvodní práce

P. SKALA^1,*, P. ZEMAN¹, J. KAUTZNER², V. HAVLAS², T. PAVELKA¹, J. MATĚJKA¹

¹ Klinika ortopedie a traumatologie pohybového ústrojí Lékařské fakulty v Plzni Univerzity Karlovy a Fakultní nemocnice Plzeň

² Klinika dětské a dospělé ortopedie a traumatologie 2. lékařské fakulty Univerzity Karlovy a Fakultní nemocnice v Motole, Praha

PURPOSE OF THE STUDY:
The aim of our prospective study was to establish correlation between the arthro-MRI and arthroscopic findings in patients active in sports clinically suspected of having a hip labral tear. We sought to identify the benefits of arthro-MRI for clinical practice prior to the considered hip arthroscopy.

MATERIAL AND METHODS:
The prospective study included 34 patients with hip pain and clinically suspected of having a labral tear. The group consisted of 19 men (55.9%) and 15 women (44.1%) of the mean age of 32.2 years (18 to 50 years). All our patients were active athletes, either professional (12; 35.3%) or recreational (22; 64.7%). Included in the study were exclusively patients aged 18-50 with hip pain lasting longer than 3 months, not responding to conservative therapy, with normal X-ray findings, or FAI syndrome.
The patients underwent arthro-MRI and subsequently also hip arthroscopy, namely within no more than 3 months. The description of findings was translated into simple numerical scales, assessed using Spearman s rank correlation coefficient. We also examined the specificity, sensitivity, positive and negative predictive values and the odds ratio at various cut-off values of the scale for arthro-MRI. The statistical significance was set at the alpha level = 5%. The quality of tests was also evaluated using the ROC curve.

RESULTS:
In hips assessed by the radiologist as reliably with no pathological finding (MRI type 1) the negative predictive value achieves 83.3% and the positive predictive value of 85.7%, with 96.0% sensitivity and 55.6% specificity. When evaluating the reliably negative finding together with the likely negative finding (MRI type 2) as against the pathological and certainly pathological findings (MRI type 3 and 4), the negative predictive value is 57.1%, the positive predictive value 95.0%, the specificity 88.9% and the sensitivity 76.0%.

DISCUSSION:
In our study, the values achieved were comparable to or better than those reported by foreign authors in their studies establishing correlations between the arthro-MRI and intraoperative findings. Significantly higher was primarily the negative predictive value.

CONCLUSIONS:
The results of our study indicate that the arthro-MRI performed as a part of preoperative examination prior to hip arthroscopy has adequate specificity and sensitivity in patients with suspected labral tear. Based on this examination a decision can be made as to whether to perform arthroscopy. Our study also shows that it is essential to have a highly competent radiologist to evaluate the arthro-MRI results.

Klíčová slova: hip arthroscopy, labral tears, arthro-MRI, hip joint, predictive value of tests, sensitivity and specificity, minimally invasive surgical procedures/methods

Zveřejněno: 1. říjen 2017  Zobrazit citaci