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术前磁共振成像测量的盂唇大小不能预测初次髋关节镜检查患者盂唇重建的必要性。

Labral size measured on preoperative magnetic resonance imaging not predictive of the need for labral reconstruction in patients undergoing primary hip arthroscopy.

作者信息

Peszek Adam, Alder Catherine C, Jamar Kyle, Wait Trevor J, Wipf Caleb J, Keeter Carson L, Mayer Stephanie W, Ho Charles P, Genuario James W

机构信息

Department of Orthopedic Surgery, University of Colorado School of Medicine, 1635 Aurora Court Anschutz Outpatient Pavilion, 4th Floor, Aurora, CO 80045, USA.

Department of Radiology-Diagnostics, University of Colorado School of Medicine, 12401 East 17th Avenue, Aurora, CO 80045, USA.

出版信息

J Hip Preserv Surg. 2024 Dec 10;12(1):20-26. doi: 10.1093/jhps/hnae043. eCollection 2025 Jan.

Abstract

Preoperative radiographic measurements may help predict which patients with hip labral tears ultimately undergo repair versus primary reconstruction. This study investigated if radiographic parameters: (i) preoperatively predict labral repair versus reconstruction and (ii) correlate with T2 magnetic resonance imaging (MRI) mapping values of the labrum. This retrospective comparative study included patients aged 14-50 years who underwent labral repair or reconstruction at a single institution over a 2-year period. Patients with prior open or arthroscopic hip surgery or who had inadequate preoperative computed tomography (CT) and MRI imaging were excluded. Labral size was measured at multiple positions on preoperative MRI images. A blinded reviewer used three-dimensional CT analysis to record lateral center edge angle (LCEA), acetabular version, Tonnis angle, acetabular coverage, alpha angle, femoral torsion, and neck-shaft angle (FNSA). T2 MRI mapping values of the labrum were obtained via sequencing analyses on each patient's optimal sagittal cut. Univariate mixed linear models were used to identify associations between each radiographic measurement and decision to repair or reconstruct the labrum. Fifty-two operations were included. Labral size had no predictive effect on undergoing labral reconstruction versus repair. Likelihood for undergoing labral reconstruction was associated with LCEA ( = .003) and Tonnis angle ( = .034). There was an association ( < .05) between labral T2 mapping values and all radiographic parameters except for FNSA and combined version. Labral size was not associated with whether patients underwent labral reconstruction or repair. The data showed an association between labrum T2 mapping values and nearly all radiographic parameters.

摘要

术前影像学测量可能有助于预测哪些髋关节盂唇撕裂患者最终会接受修复手术还是初次重建手术。本研究调查了影像学参数:(i)术前能否预测盂唇修复与重建手术,以及(ii)是否与盂唇的T2磁共振成像(MRI)映射值相关。这项回顾性比较研究纳入了年龄在14至50岁之间、在两年内于单一机构接受盂唇修复或重建手术的患者。排除了既往有开放性或关节镜髋关节手术史或术前计算机断层扫描(CT)和MRI成像不充分的患者。在术前MRI图像的多个位置测量盂唇大小。一位不知情的评估者使用三维CT分析记录外侧中心边缘角(LCEA)、髋臼旋转、托尼斯角、髋臼覆盖度、α角、股骨扭转和颈干角(FNSA)。通过对每位患者最佳矢状切面的序列分析获得盂唇的T2 MRI映射值。使用单变量混合线性模型确定每个影像学测量值与盂唇修复或重建决策之间的关联。共纳入52例手术。盂唇大小对接受盂唇重建还是修复没有预测作用。接受盂唇重建的可能性与LCEA(=0.003)和托尼斯角(=0.034)相关。除FNSA和联合旋转外,盂唇T2映射值与所有影像学参数之间存在关联(<0.05)。盂唇大小与患者是否接受盂唇重建或修复无关。数据显示盂唇T2映射值与几乎所有影像学参数之间存在关联。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/25aa/12051866/1e698affc263/hnae043f1.jpg

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