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Cam-type femoroacetabular im**ement—correlations between alpha angle versus volumetric measurements and surgical findings

  • Musculoskeletal
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Aim

Determine correlations of 3DCT cam-type femoroacetabular im**ement (FAI) measurements with surgical findings of labral tear and cartilage loss.

Methods

Digital search of symptomatic cam-type FAI from July 2013 to August 2016 yielded 43 patients. Two readers calculated volumes of femoral head, bump, and alpha angles on 3DCT images. Correlations between CT and surgical findings, inter-, and intra-reader reliabilities were assessed using Spearman rank correlation and intraclass correlation coefficients (ICC).

Results

Thirteen men and 14 women aged 37 ± 10 (mean ± SD) years were included. Most common clinical finding was positive flexion–adduction–internal rotation (70.4%). Twenty-seven labral tears and 20 cartilage defects were surgically detected. Significant correlations existed between femoral bump, head volumes, and extent of the labral tear (p = 0.008 and 0.003). No significant correlations were found between the alpha angles at 12 to 3 o’clock and the extent of labral tear (p = 0.2, 0.8, 0.9, and 0.09) or any measurement with the cartilage loss (p values for alpha 12 to 3, bump, and head volumes = 0.7, 0.3, 0.9, 0.9, 0.07, and 0.2). Inter- and intra-reader reliabilities were excellent to moderate for femoral head and bump volumes (ICC = 0.85, 0.52, and 0.8, 0.5) and moderate to poor for alpha angles (ICC = 0.48, 0.40, 0.05, 0.25 and 0.3, 0.24, 0.29, 0.49).

Conclusion

Three dimensional volumetric measurements of cam-type FAI significantly correlate with the extent of intraoperative labral tears. Superior inter- and intra-reader reliability to that of alpha angles renders it a more clinically relevant measurement for quantifying cam morphology.

Key Points

• The 3DCT bump volume and femoral head volume showed significant correlations with the extent of labral tear (p values = 0.008 and 0.003).

• No significant correlations were seen between alpha angles and the extent of labral tear (p values > 0.05).

• Inter- and intra-reader reliability was excellent to moderate (ICC = 0.85 and 0.52, 0.8, and 0.5) for femoral head and bump volumes while inter- and intra-reader reliability was fair to poor (ICC = 0.48, 0.40, 0.05, 0.25 and 0.3, 0.24, 0.29, 0.49) for alpha angles.

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Abbreviations

3DCT:

Three-dimensional computed tomography

FABER:

Flexion-abduction-external rotation

FADIR:

Flexion-adduction-internal rotation

FAI:

Femoroacetabular im**ement

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Funding

The authors state that this work has not received any funding.

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Authors and Affiliations

  1. Department of Radiology, Zagazig University Hospitals and Faculty of Medicine, Zagazig University, Koliat Al Tob Street, Zagazig, 44519, Egypt

    Riham Dessouky

  2. Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Avneesh Chhabra, Lihua Zhang, Adam Gleason, Rajiv Chopra, Yonatan Chatzinoff & Yin **

  3. Department of Orthopedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Avneesh Chhabra & Joel Wells

  4. Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Rajiv Chopra

  5. Departments of Bioengineering and Mechanical Engineering, The University of Texas at Dallas, Richardson, TX, USA

    Nicholas P. Fey

  6. Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Nicholas P. Fey

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  1. Riham Dessouky
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  9. Joel Wells
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Correspondence to Joel Wells.

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Guarantor

The scientific guarantor of this publication is Avneesh Chhabra, MD.

Conflict of interest

The authors of this manuscript declare relationships with the following companies:

RD, LZ, AG, RC, YC, NPF: no conflicts of interest.

AC: consultant ICON Medical, royalties: Jaypee, Wolters (not related).

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One of the authors has significant statistical expertise.

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Dessouky, R., Chhabra, A., Zhang, L. et al. Cam-type femoroacetabular im**ement—correlations between alpha angle versus volumetric measurements and surgical findings. Eur Radiol 29, 3431–3440 (2019). https://doi.org/10.1007/s00330-018-5968-z

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