Do patients with femoroacetabular impingement syndrome who undergo hip arthroscopy display improved alpha angle (magnetic resonance imaging) and radiographic hip morphology?

Aricia Jieqi Thirumaran; Nicholas J. Murphy; Jillian Peta Eyles; James M Linklater; Stephan Reichenbach; Florian Schmaranzer; Till D. Lerch; Venkatesha Venkatesha; Gillian Heller; John O'Donnell; David J. Hunter

doi:10.1111/1756-185X.14530

Do patients with femoroacetabular impingement syndrome who undergo hip arthroscopy display improved alpha angle (magnetic resonance imaging) and radiographic hip morphology?

Aricia Jieqi Thirumaran, Nicholas J. Murphy, Jillian Peta Eyles, James M Linklater, Stephan Reichenbach, Florian Schmaranzer, Till D. Lerch, Venkatesha Venkatesha, Gillian Heller, John O'Donnell, David J. Hunter^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

1 Citation (Scopus)

63 Downloads (Pure)

Abstract

Aims: To compare (a) the change in radiological bony morphology between participants with femoroacetabular impingement (FAI) syndrome who underwent arthroscopic hip surgery compared to physiotherapist-led non-surgical care and (b) the change in radiological bony morphology between participants with FAI syndrome who underwent arthroscopic hip surgery involving cam resection or acetabular rim trimming or combined cam resection and acetabular rim trimming.

Methods: Maximum alpha angle measurements on magnetic resonance imaging and Hip²Norm standardized hip measurements on radiographs were recorded at baseline and at 12 months postoperatively. One-way analysis of covariance and independent T tests were conducted between participants who underwent arthroscopic hip surgery and physiotherapist-led non-surgical care. Independent T tests and analysis of variance were conducted between participants who underwent the 3 different arthroscopic hip procedures.

Results: Arthroscopic hip surgery resulted in significant improvements to mean alpha angle measurements (decreased from 70.8° to 62.1°) (P value <.001, 95% CI −11.776, −4.772), lateral center edge angle (LCEA) (P value =.030, 95% CI −3.403, −0.180) and extrusion index (P value = 0.002, 95% CI 0.882, 3.968) compared to physiotherapist-led management. Mean maximum 1-year postoperative alpha angle was 59.0° (P value =.003, 95% CI 4.845, 18.768) for participants who underwent isolated cam resection. Measurements comparing the 3 different arthroscopic hip procedures only differed in total femoral head coverage (F[2,37] = 3.470, P =.042).

Conclusion: Arthroscopic hip surgery resulted in statistically significant improvements to LCEA, extrusion index and alpha angle as compared to physiotherapist-led management. Measured outcomes between participants who underwent cam resection and/or acetabular rim trimming only differed in total femoral head coverage.

Original language	English
Pages (from-to)	354-359
Number of pages	6
Journal	International Journal of Rheumatic Diseases
Volume	26
Issue number	2
DOIs	https://doi.org/10.1111/1756-185X.14530
Publication status	Published - Feb 2023

Bibliographical note

Copyright © 2022 The Authors. International Journal of Rheumatic Diseases published by Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

Keywords

arthroscopic surgery
computer assisted radiographic image interpretation
femoroacetabular impingement
hip osteoarthritis
physiotherapy

Access to Document

10.1111/1756-185X.14530Licence: CC BY

Publisher version (open access)Final published version, 516 KBLicence: CC BY

Cite this

Thirumaran, A. J., Murphy, N. J., Eyles, J. P., Linklater, JM., Reichenbach, S., Schmaranzer, F., Lerch, T. D., Venkatesha, V., Heller, G., O'Donnell, J., & Hunter, D. J. (2023). Do patients with femoroacetabular impingement syndrome who undergo hip arthroscopy display improved alpha angle (magnetic resonance imaging) and radiographic hip morphology? International Journal of Rheumatic Diseases, 26(2), 354-359. https://doi.org/10.1111/1756-185X.14530

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title = "Do patients with femoroacetabular impingement syndrome who undergo hip arthroscopy display improved alpha angle (magnetic resonance imaging) and radiographic hip morphology?",

abstract = "Aims: To compare (a) the change in radiological bony morphology between participants with femoroacetabular impingement (FAI) syndrome who underwent arthroscopic hip surgery compared to physiotherapist-led non-surgical care and (b) the change in radiological bony morphology between participants with FAI syndrome who underwent arthroscopic hip surgery involving cam resection or acetabular rim trimming or combined cam resection and acetabular rim trimming.Methods: Maximum alpha angle measurements on magnetic resonance imaging and Hip2Norm standardized hip measurements on radiographs were recorded at baseline and at 12 months postoperatively. One-way analysis of covariance and independent T tests were conducted between participants who underwent arthroscopic hip surgery and physiotherapist-led non-surgical care. Independent T tests and analysis of variance were conducted between participants who underwent the 3 different arthroscopic hip procedures.Results: Arthroscopic hip surgery resulted in significant improvements to mean alpha angle measurements (decreased from 70.8° to 62.1°) (P value <.001, 95% CI −11.776, −4.772), lateral center edge angle (LCEA) (P value =.030, 95% CI −3.403, −0.180) and extrusion index (P value = 0.002, 95% CI 0.882, 3.968) compared to physiotherapist-led management. Mean maximum 1-year postoperative alpha angle was 59.0° (P value =.003, 95% CI 4.845, 18.768) for participants who underwent isolated cam resection. Measurements comparing the 3 different arthroscopic hip procedures only differed in total femoral head coverage (F[2,37] = 3.470, P =.042).Conclusion: Arthroscopic hip surgery resulted in statistically significant improvements to LCEA, extrusion index and alpha angle as compared to physiotherapist-led management. Measured outcomes between participants who underwent cam resection and/or acetabular rim trimming only differed in total femoral head coverage.",

keywords = "arthroscopic surgery, computer assisted radiographic image interpretation, femoroacetabular impingement, hip osteoarthritis, physiotherapy",

author = "Thirumaran, {Aricia Jieqi} and Murphy, {Nicholas J.} and Eyles, {Jillian Peta} and James M Linklater and Stephan Reichenbach and Florian Schmaranzer and Lerch, {Till D.} and Venkatesha Venkatesha and Gillian Heller and John O'Donnell and Hunter, {David J.}",

note = "Copyright {\textcopyright} 2022 The Authors. International Journal of Rheumatic Diseases published by Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.",

year = "2023",

month = feb,

doi = "10.1111/1756-185X.14530",

language = "English",

volume = "26",

pages = "354--359",

journal = "International Journal of Rheumatic Diseases",

issn = "1756-1841",

publisher = "Wiley-Blackwell, Wiley",

number = "2",

}