PMID- 35364263
OWN - NLM
STAT- MEDLINE
DCOM- 20221109
LR  - 20221209
IS  - 1526-3231 (Electronic)
IS  - 0749-8063 (Linking)
VI  - 38
IP  - 11
DP  - 2022 Nov
TI  - Preoperative Magnetic Resonance Imaging Offers Questionable Clinical Utility, 
      Delays Time to Hip Arthroscopy, and Lacks Cost-Effectiveness in Patients Aged </=40 
      Years With Femoroacetabular Impingement Syndrome: A Retrospective 5-Year 
      Analysis.
PG  - 3013-3019
LID - S0749-8063(22)00194-3 [pii]
LID - 10.1016/j.arthro.2022.03.025 [doi]
AB  - PURPOSE: To assess the clinical utility of preoperative magnetic resonance 
      imaging (MRI) and quantify the delay in surgical care for patients aged </=40 years 
      undergoing primary hip arthroscopy with history, physical examination, and 
      radiographs concordant with femoroacetabular impingement syndrome (FAIS). 
      METHODS: From August 2015 to December 2020, 1,786 consecutive patients were 
      reviewed from the practice of 1 fellowship-trained hip arthroscopist. Inclusion 
      criteria were FAIS, primary surgery, and age </=40 years. Exclusion criteria were 
      MRI contraindication, reattempt of conservative management, or concomitant 
      periacetabular osteotomy. After nonoperative treatment options were exhausted and 
      a surgical plan was established, patients were stratified by those who presented 
      with versus without MRI. Those without existing MRI received one, and any 
      deviations from the surgical plan were noted. All preoperative MRIs were compared 
      with office evaluation and intraoperative findings to assess agreement. 
      Demographic data, Hip Disability and Osteoarthritis Outcome Score (HOOS)-Pain, 
      and time from office to MRI or arthroscopy were recorded. RESULTS: Of the 
      patients indicated by history, physical examination, and radiographs alone (70% 
      female, body mass index 24.8 kg/m(2), age 25.9 years), 198 patients presented 
      without MRI and 934 with MRI. None of the 198 had surgical plans altered after 
      MRI. Patients in both groups had MRI findings demonstrating anterosuperior labral 
      tears that were visualized and repaired intraoperatively. Mean time from office 
      to arthroscopy for patients without MRI versus those with was 107.0 +/- 67 and 85.0 
      +/- 53 days, respectively (P < .001). Time to MRI was 22.8 days. No difference 
      between groups was observed among the 85% of patients who surpassed the HOOS-Pain 
      minimal clinically important difference (MCID). CONCLUSION: Once indicated for 
      surgery based on history, physical examination, and radiographs, preoperative MRI 
      did not alter the surgical plan for patients aged </=40 years with FAIS undergoing 
      primary hip arthroscopy. Moreover, preoperative MRI delayed time to arthroscopy. 
      The necessity of routine preoperative MRI in the young primary FAIS population 
      should be challenged.
CI  - Copyright (c) 2022 Arthroscopy Association of North America. Published by Elsevier 
      Inc. All rights reserved.
FAU - Ramkumar, Prem N
AU  - Ramkumar PN
AD  - Department of Orthopaedic Surgery, Brigham & Women's Hospital, Boston, 
      Massachusetts, U.S.A.; Center for Hip Preservation, Hospital for Special Surgery, 
      New York, New York, U.S.A.. Electronic address: premramkumar@gmail.com.
FAU - Helm, J Matthew
AU  - Helm JM
AD  - Department of Orthopaedic Surgery, McGovern Medical School University of Texas 
      Health Science Center, Houston, Texas, U.S.A.
FAU - Berrier, Ava S
AU  - Berrier AS
AD  - Department of Orthopaedic Surgery, Baylor College of Medicine, Houston, Texas, 
      U.S.A.
FAU - Vega, Jose F
AU  - Vega JF
AD  - Sports Health Center, Cleveland Clinic, Cleveland, Ohio, U.S.A.
FAU - Yalcin, Sercan
AU  - Yalcin S
AD  - Department of Sports Medicine, Yale School of Medicine, New Haven, Connecticut, 
      U.S.A.
FAU - Kunze, Kyle N
AU  - Kunze KN
AD  - Center for Hip Preservation, Hospital for Special Surgery, New York, New York, 
      U.S.A.
FAU - Harris, Joshua D
AU  - Harris JD
AD  - Houston Methodist Orthopedics & Sports Medicine, Houston, Texas, U.S.A.
FAU - Nwachukwu, Benedict U
AU  - Nwachukwu BU
AD  - Center for Hip Preservation, Hospital for Special Surgery, New York, New York, 
      U.S.A.
LA  - eng
PT  - Journal Article
DEP - 20220329
PL  - United States
TA  - Arthroscopy
JT  - Arthroscopy : the journal of arthroscopic & related surgery : official 
      publication of the Arthroscopy Association of North America and the International 
      Arthroscopy Association
JID - 8506498
SB  - IM
CIN - Arthroscopy. 2022 Nov;38(11):3020-3022. PMID: 36344059
MH  - Humans
MH  - Female
MH  - Male
MH  - *Femoracetabular Impingement/diagnostic imaging/surgery
MH  - Arthroscopy/methods
MH  - Retrospective Studies
MH  - Cost-Benefit Analysis
MH  - Treatment Outcome
MH  - Activities of Daily Living
MH  - Magnetic Resonance Imaging
MH  - Pain
MH  - Hip Joint/diagnostic imaging/surgery
MH  - Patient Reported Outcome Measures
MH  - Follow-Up Studies
EDAT- 2022/04/02 06:00
MHDA- 2022/11/10 06:00
CRDT- 2022/04/01 20:11
PHST- 2022/02/06 00:00 [received]
PHST- 2022/03/11 00:00 [revised]
PHST- 2022/03/11 00:00 [accepted]
PHST- 2022/04/02 06:00 [pubmed]
PHST- 2022/11/10 06:00 [medline]
PHST- 2022/04/01 20:11 [entrez]
AID - S0749-8063(22)00194-3 [pii]
AID - 10.1016/j.arthro.2022.03.025 [doi]
PST - ppublish
SO  - Arthroscopy. 2022 Nov;38(11):3013-3019. doi: 10.1016/j.arthro.2022.03.025. Epub 
      2022 Mar 29.