Steadman Philippon Research Institute, Vail, Colorado, U.S.A.; Steadman Clinic and United States Coalition for the Prevention of Illness and Injury in Sport, Vail, Colorado, U.S.A.
Steadman Philippon Research Institute, Vail, Colorado, U.S.A.
Arthroscopy. 2024 Feb;40(2):320-327. doi: 10.1016/j.arthro.2023.05.030. Epub 2023 Jun 23.
To compare preoperative magnetic resonance imaging (MRI) and intraoperative measurements of labral width and determine whether MRI can reliably predict labral width in the setting of revision surgery.
Patients who underwent revision 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 scans at 3 standardized locations using the clock-face method. Interobserver and intraobserver reliabilities were calculated, and comparisons between intraoperatively measured labral widths and MRI measurements were performed.
Fifty-eight patients who underwent revision hip arthroscopy were enrolled in the study. The average labral width measurements at the 3-, 12-, and 9-o'clock positions were 7.4 mm (standard deviation [SD], 1.2 mm), 7.5 mm (SD, 1.4 mm), and 6.6 mm (SD, 1.2 mm), respectively, on MRI compared with 6.7 mm (SD, 2.1 mm), 6.5 mm (SD, 2.5 mm), and 7.0 mm (SD, 1.9 mm), respectively, when measured intraoperatively. The average intraoperative measurements were smaller than the MRI measurements at the 3-o'clock (P = .03) and 12-o'clock (P = .01) positions. The inter-rater intraclass correlation coefficients between the 2 surgeons exhibited good agreement (0.612) at the 3-o'clock position, fair agreement (0.498) at the 12-o'clock position, and poor agreement (0.171) at the 9-o'clock position. The positive predictive values of the MRI measurements were 72% at the 3-o'clock position, 68% at the 12-o'clock position, and 88% at the 9-o'clock position for identifying a labral width of 6 mm or greater.
The results of this study show that MRI-measured labral width and actual labral width measured at the time of revision arthroscopy are usually within 1 mm of each other.
Level II, diagnostic study investigating diagnostic test.
比较术前磁共振成像（MRI）与术中测量的盂唇宽度，并确定 MRI 是否能在翻修手术中可靠地预测盂唇宽度。
回顾性分析了 2008 年 1 月至 2015 年 12 月期间由同一位外科医生进行的关节镜下髋关节翻修手术的患者。术中测量了盂唇的宽度。两名骨科医生使用时钟面法在 3 个标准化位置对 MRI 扫描进行盂唇宽度测量。计算了观察者间和观察者内的可靠性，并对术中测量的盂唇宽度与 MRI 测量值进行了比较。
本研究共纳入 58 例接受髋关节镜下翻修手术的患者。MRI 测量的 3 点、12 点和 9 点位置的盂唇平均宽度分别为 7.4mm（标准差[SD]，1.2mm）、7.5mm（SD，1.4mm）和 6.6mm（SD，1.2mm），而术中测量的相应位置的盂唇平均宽度分别为 6.7mm（SD，2.1mm）、6.5mm（SD，2.5mm）和 7.0mm（SD，1.9mm）。术中测量的平均值小于 MRI 测量值，3 点（P=.03）和 12 点（P=.01）位置的差异有统计学意义。两名外科医生之间的组内 ICC 显示，3 点位置的一致性较好（0.612），12 点位置的一致性一般（0.498），9 点位置的一致性较差（0.171）。MRI 测量值在 3 点位置的阳性预测值为 72%，在 12 点位置的阳性预测值为 68%，在 9 点位置的阳性预测值为 88%，可识别出 6mm 或更大的盂唇宽度。
本研究结果表明，MRI 测量的盂唇宽度与翻修关节镜术中实际测量的盂唇宽度通常相差 1mm 以内。
Ⅱ级，研究诊断测试的诊断研究。
