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Radiographic findings may be used to predict likelihood of THR following arthroscopy for FAI

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Carl Wierks

SAN DIEGO — Preoperative radiographs may be effectively used to gauge the prognosis for patient outcomes as they relate to osteoarthritis following arthroscopy for femoroacetabular impingement, according to a study presented at the 2011 Annual Meeting of the American Academy of Orthopaedic Surgeons.

Presence of significant joint space narrowing, acetabular sclerosis and medial acetabular osteophyte formation are all indicators of future total hip arthroplasty, presenter Carl Wierks, MD, said.

“The purpose of this study was to determine which radiographic measurements were predictors of total hip replacement following hip arthroscopy for [femoracetabular impingement],” Wierks said.

A retrospective review

The researchers retrospectively reviewed 115 preoperative anterior/posterior pelvis radiographs of patients who underwent hip arthroscopy for labral tears secondary to femoroacetabular impingement. Utilizing a minimum of 3-year postoperative outcome data, the team performed a radiographic assessment of the lateral acetabular margin, the acetabular fossa, the infermedial acetabular floor, the lateral femoral head-neck junction, the superior weightbearing aspect of the femoral head, the medial aspect of the femoral head and the inferior aspect of the femoral head for evidence of sclerosis, cyst formation and osteophyte presence.

Wierks reported 29 of the 115 patients progressed to total hip arthroplasty, with positive correlations being found between higher total hip arthroplasty rates and acetabular sclerosis, as well as osteophyte formation at the lateral femur head-neck junction, the inferomedial acetabular floor, and the acetabular fossa.

Sclerosis of the femoral weightbearing surface, osteophytes in the lateral acetabular rim and femoral or acetabular cysts were all found not to correlate with increased risk of total hip arthroplasty.

“Radiographic assessment is critical when screening patients for hip arthroscopy,” Wierks concluded. “These common radiographic scales can be used to determine who is at increased risk of going on to a total hip replacement, and patients should be counseled of these risks preoperatively.”

Reference:

• Carlisle J, Philippon MJ, Souza BGS, Briggs KK. Radiologic predictors of THR following arthroscopy for femoracetabular impingement. Paper #638. Presented at the 2011 Annual Meeting of the American Academy of Orthopaedic Surgeons. Feb. 15-19. San Diego.
• Disclosure: Wierks has no relevant financial disclosures.

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