ePoster #736 - ISHA Annual Scientific Meeting 2016

Preoperative Ct Imaging Of The Hip Does Not Improve Clinical Outcomes In Patients With Femoroacetabular Impingement Treated With Hip Arthroscopy

Graeme Whyte, MD, MSc, FRCSC, New York, NY UNITED STATES
Michael K Ryan, MD, New York, NY UNITED STATES
Theodore Wolfson, MD, New York, NY UNITED STATES
Mathew Hamula, MD, New York, NY UNITED STATES
Kristofer Chenard, MD, New York, NY UNITED STATES
Brian Capogna, MD, New York, NY UNITED STATES
John P Begly, MD, New York, NY UNITED STATES
Christopher A Looze, MD, New York, NY UNITED STATES
Thomas Youm, MD, New York, NY UNITED STATES

NYU Hospital for Joint Diseases, New York, NY, UNITED STATES

FDA Status Cleared

Summary: CT imaging with multiplanar reformatting may be used preoperatively to better visualize the bony anatomy about the hip and for surgical planning in cases of femoroacetabular impingement. This study has demonstrated that preoperative CT imaging does not improve clinical outcomes in cases of femoroacetabular impingement treated with hip arthroscopy.

Abstract:
Introduction: CT imaging with multiplanar reformatting may be used preoperatively to completely detail femoroacetabular bony anatomy prior to arthroscopic treatment of femoroacetabular impingement. The purpose of this study is to compare the clinical outcomes of those patients who did or did not have preoperative CT imaging of the hip, in a cohort of patients treated arthroscopically for femoroacetabular impingement. Methods. A prospective database of patients diagnosed with femoroacetabular impingement and treated with hip arthroscopy at our institution was reviewed. Clinical outcomes were assessed using patient-reported outcome tools that consisted of the modified Harris Hip Score (mHHS) and the Nonarthritic Hip Score (NAHS). A comparative analysis of clinical outcomes was performed between those patients who underwent preoperative CT imaging of the hip, and those who did not. A comparative subanalysis examined the association of preoperative CT imaging in patients who underwent revision hip arthroscopy. Results. There were 441 patient cases of femoroacetabular impingement treated with hip arthroscopy analyzed, with a mean age of 40.2 years and a mean follow-up duration of 20.6 months (range 12 to 36 months). There were 312 cases with a minimum follow-up of 2 years. Preoperative CT imaging with multiplanar reformatting was performed in 26 patients. The mean mHHS of 83.6 at final follow-up was significantly greater than the mean preoperative score of 49.6 (p<0.001). The mean NAHS of 84.1 at final follow-up was significantly greater than the mean preoperative score of 47.5 (p<0.001). The mean preoperative mHHS and NAHS were similar between patients who did or did not undergo preoperative CT imaging (p=0.485 and p=0.287, respectively). Clinical outcomes at final follow-up were significantly decreased in those who underwent preoperative CT imaging compared to those who did not according to the mHHS (73.3 vs 84.3, p<0.001) and NAHS (72.2 vs 84.8, p<0.001). Subanalysis of revision hip arthroscopy cases did not demonstrate any difference in final outcome for those patients who underwent preoperative CT imaging according to the mHHS (p=0.397) or NAHS (p=0.139). Conclusions. Preoperative CT imaging with multiplanar reformatting does not lead to improved short-term clinical outcomes in patients who undergo arthroscopic treatment of femoroacetabular impingement.