2021 ISAKOS Biennial Congress ePoster
Use Of Preoperative Magnetic Resonance Imaging To Predict Clinical Outcomes Following Core Muscle Injury Repair
Matthew J. Kraeutler, MD, Houston, TX UNITED STATES
Jennifer Kurowicki, MD UNITED STATES
Iciar M Davila Castrodad, MD, Wayne, NJ UNITED STATES
Edward Milman, MD, Paterson, NJ UNITED STATES
Toghrul Talishinskiy, MD, Paterson, NJ UNITED STATES
Anthony Scillia, Birmingham, AL UNITED STATES
St. Joseph's University Medical Center, Paterson, NJ, UNITED STATES
FDA Status Not Applicable
Summary
Patients with preoperative magnetic resonance imaging (MRI) consistent with core muscle injury (CMI) may experience greater improvement in pain postoperatively, though MRI does not predict postoperative activity level in these patients.
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Abstract
Background
Core muscle injury (CMI), often referred to as a sports hernia or athletic pubalgia, is a common cause of groin pain in athletes. Imaging modalities used to assist in the diagnosis of CMI include ultrasound (US) and magnetic resonance imaging (MRI).
Purpose
The purpose of this study was to determine if preoperative MRI findings predict clinical outcomes following surgery for core muscle injury.
Methods
A retrospective cohort study was performed on a consecutive series of patients who underwent surgery for CMI by the senior author. CMI was diagnosed based on history, physical examination, and a positive US. In addition, all patients underwent a preoperative MRI which was read by a musculoskeletal fellowship-trained radiologist. Patients were divided into two groups depending on whether the MRI was interpreted as positive or negative for CMI. All patients underwent mini-open CMI repair. Patient-reported outcomes (PROs) were collected pre- and postoperatively including the visual analog scale (VAS) for pain; University of California, Los Angeles (UCLA) Activity score; and the modified Harris Hip Score (mHHS).
Results
A total of 39 hips were included in this study, of which 17 had a positive MRI interpretation for CMI (44%) and 22 had a negative MRI interpretation (56%). Mean age at the time of surgery was 35 years (range, 17-56 years) and mean follow-up was 21 months (range, 12-35 months). No significant difference was found between groups in mean age or time to follow-up. Patients in both groups demonstrated significant improvement from preoperative to most recent follow-up in terms of the UCLA Activity score (p < 0.05). VAS scores significantly improved for patients with a positive MRI interpretation (p = 0.001), but did not significantly improve among those with a negative MRI interpretation (p = 0.094). No significant difference in any PROs was found between groups at most recent follow-up.
Conclusion
Successful clinical outcomes can be expected in patients undergoing surgery for CMI diagnosed based on history, physical examination, and ultrasound. Patients with a preoperative MRI consistent with CMI may experience greater improvement in pain postoperatively, though MRI does not predict postoperative activity level in these patients.