Purpose
To investigate the relation of hip capsular thickness as measured on preoperative
magnetic resonance imaging (MRI) and intraoperative hip joint axial distraction distance
on an examination under anesthesia.
Methods
A retrospective review of primary arthroscopic hip procedures performed between November
2018 and June 2021 was conducted. The inclusion criteria included a diagnosis of femoroacetabular
impingement syndrome and preoperative radiographic imaging and MRI. Fluoroscopic images
were obtained at 0 lb and 100 lb of axial traction force. Total distraction distance
was calculated by comparing the initial joint space with the total joint space at
100 lb. Hip capsular thickness was measured on MRI. Analysis was conducted using multiple
linear regression, independent-samples t tests, and Mann-Whitney U tests.
Results
Eighty patients were included. Bivariable regression showed an association between
an increased distraction distance and female sex (β = 4.303, R = 0.561, P < .001), as well as decreased anterior axial (β = –1.291, R = 0.365, P < .001) and superior coronal (β = –1.433, R = 0.501, P < .001) capsular thickness. Multivariable regression (R = 0.645) showed an association between an increased distraction distance and female
sex (β = 3.175, P < .001), as well as decreased superior coronal capsular thickness (β = –0.764, P = .022). Independent-samples t tests showed that female patients had significantly decreased superior coronal capsular
thickness (2.92 ± 1.14 mm vs 3.99 ± 1.15 mm, P < .001).
Conclusions
Female sex and decreased hip capsular thickness in the superior aspect of the coronal
plane on magnetic resonance scans were found to be predictors of increased hip joint
axial distraction distance on examination under anesthesia prior to hip arthroscopy,
with anterior axial capsular thickness being a moderate predictor. Poor predictors
of distraction distance were posterior axial and inferior coronal capsular thickness,
age, body mass index, and lateral center-edge angle. Female patients were also found
to have thinner hip capsules in the superior region, which may explain the association
between female patients and increased distraction. These findings further characterize
the relation between capsular thickness and hip laxity.
Level of Evidence
Level IV, case series.
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Article Info
Publication History
Published online: May 09, 2022
Accepted:
April 19,
2022
Received:
November 24,
2021
Publication stage
In Press Journal Pre-ProofFootnotes
The authors report the following potential conflicts of interest or sources of funding: S.K.A. receives personal fees for consulting from Stryker; personal fees for travel and lodging from Stryker; personal fees for food and beverage from Stryker and Smith & Nephew; and personal fees for education support from Active Medical, outside the submitted work. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Identification
Copyright
© 2022 by the Arthroscopy Association of North America
