Combined 3-Dimensional CT and Multidirectional CT Arthrography for Femoroacetabular Impingement and Hip Lesions: A Cross-sectional Study Comparing Imaging and Hip Arthroscopic Surgery Findings

Chieh-An Chuang; Huan Sheu; Cheng-Pang Yang; Hao-Che Tang; Chen-Te Wu; Chen-Ju Fu; Yi-Sheng Chan

doi:10.1177/23259671221143459

Combined 3-Dimensional CT and Multidirectional CT Arthrography for Femoroacetabular Impingement and Hip Lesions: A Cross-sectional Study Comparing Imaging and Hip Arthroscopic Surgery Findings

Orthop J Sports Med. 2023 Jan 9;11(1):23259671221143459. doi: 10.1177/23259671221143459. eCollection 2023 Jan.

Authors

Chieh-An Chuang^{1

2

3}, Huan Sheu^{1

2

3}, Cheng-Pang Yang^{1

2

3}, Hao-Che Tang^{3

4}, Chen-Te Wu⁵, Chen-Ju Fu⁵, Yi-Sheng Chan^{1

2

3

4}

Affiliations

¹ Division of Sports Medicine, Department of Orthopaedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan.
² Bone and Joint Research Center, Linkou Chang Gung Memorial Hospital, Taoyuan.
³ Comprehensive Sports Medicine Center, Linkou Chang Gung Memorial Hospital, Taoyuan.
⁴ Department of Orthopaedic Surgery, Keelung Chang Gung Memorial Hospital, Keelung.
⁵ Department of Medical Imaging and Intervention, Linkou Chang Gung Memorial Hospital, Taoyuan.

Abstract

Background: There is limited research investigating the diagnostic strength of 3-dimensional computed tomography (3D-CT) and multidirectional CT arthrography (CTA) for femoroacetabular impingement (FAI) and related hip lesions.

Purpose: To evaluate the diagnostic strength of combined 3D-CT and CTA in patients with FAI and related hip lesions by comparing it with hip arthroscopic surgery findings.

Study design: Cohort study (diagnosis); Level of evidence, 2.

Methods: This study included patients who were suspected of having FAI and related hip lesions and who underwent a combination of 3D-CT and CTA and subsequent hip arthroscopic surgery between December 2013 and December 2017. The CT and intraoperative arthroscopic findings were recorded and compared. The sensitivity, specificity, and accuracy of 3D-CT for FAI and those of CTA for related hip lesions were calculated.

Results: A total of 114 patients with 114 hips were included in our study. There were 101 patients with positive findings and 13 patients with negative findings for FAI (including cam, pincer, and combined morphology) according to 3D-CT. The sensitivity, specificity, and accuracy of 3D-CT for FAI were 91.58%, 57.14%, and 89.47%, respectively. The sensitivity, specificity, and accuracy of CTA for labral tears were 94.64%, 100.00%, and 94.73%, respectively. For acetabular cartilage defects, the sensitivity, specificity, and accuracy of CTA were 60.71%, 91.37%, and 76.31%, respectively. For femoral cartilage defects, the sensitivity, specificity, and accuracy of CTA were 82.22%, 76.81%, and 78.94%, respectively.

Conclusion: The study results indicated that 3D-CT was able to provide excellent accuracy for FAI compared with hip arthroscopic surgery findings. In addition, multidirectional CTA demonstrated promising diagnostic strength for hip lesions such as labral tears and chondral defects.

Keywords: 3-dimensional computed tomography; computed tomography arthrography; femoroacetabular impingement; hip arthroscopic surgery; hip cartilage defect; hip labral tear.