Summary: Intra-articular gadolinium for magnetic resonance arthrogram administered concurrently with a diagnostic intra-articular anesthetic injection can result in a false negative response to the diagnostic injection, but is not a negative predictor of short-term surgical outcomes after hip arthroscopy.

Introduction

Magnetic resonance arthrography (MRA) with intra-articular gadolinium and diagnostic intra-articular anesthetic injections (DIAI) are important tools in the evaluation of young patients with hip pathology and are often performed concurrently. However, some authors have questioned whether concurrent gadolinium administration can lead to false negative DIAI due to post-arthrography pain.

Methods

Patients receiving a series of two diagnostic intra-articular hip injections with anesthetic, the first with gadolinium for concurrent MRA and the second without gadolinium, were retrospectively identified. Pain response to diagnostic injection, injectate volume, local anesthetic volume, inclusion of corticosteroids, and method of injection were compared between injections. False negative injection was defined as <50% pain relief with concurrent gadolinium, but > or =50% pain relief with subsequent anesthetic injection without gadolinium. False negative injections in patients that ultimately underwent primary hip arthroscopy were identified from this cohort and matched in a 3:1 ratio to a control cohort to compare post-operative single assessment numerical evaluation (SANE) scores.

Results

Forty-three patients underwent a series of anesthetic injections with and without gadolinium and met inclusion and exclusion criteria. Pain response was significantly different in injections performed with and without gadolinium (18% vs. 81%; p<0.001). There were significant differences in total injectate volume, local anesthetic volume, corticosteroid use, and method of injection between injections, but these variables were not correlated with pain response based on Spearman's correlation tests. Fifteen patients had false negative responses to injection with gadolinium and were matched in a 3:1 ratio to a control cohort. There was no difference in post-operative SANE scores between the gadolinium-sensitive and control groups (81.6 vs. 80.0, p>0.05) collected at an average one year post-operatively.

Conclusion

Concurrent administration of intra-articular gadolinium with DIAI may result in a false negative response to anesthetic. Additionally, in patients with initial false negative DIAI with gadolinium followed by response to a second injection without gadolinium, short-term post-operative outcomes after hip arthroscopy are similar to a matched cohort.

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Mid-Term Outcome and Strength Assessment after Proximal Rectus-Femoris-Refixation in Athletes ePoster Presentation Maximilian Hinz, MD, GERMANY Stephanie Geyer, MD, GERMANY Felix Winden, Cand Med, GERMANY Alexander Braunsperger, B.Sc., GERMANY Florian Kreuzpointner, PhD, GERMANY Benjamin Daniel Kleim, MBBS, MD, MRes, GERMANY Andreas B. Imhoff, MD, Prof. Emeritus, GERMANY Julian Mehl, MD, GERMANY
“X-Square” Technique For Radial Meniscal Root Tear ePoster Presentation Winyou Ratanachai, MD.M Ch(Orth)., THAILAND Keerati Klinchanhom, MD, THAILAND
Utilizing Laser Doppler Flowmetry To Measure Labral Blood Flow During Arthroscopic Acetabular Labral Repair Abstract Presentation 5 minutes Paul F Abraham, BS, UNITED STATES Mark R. Nazal, MPH, UNITED STATES Nathan Varady, MD, MBA, UNITED STATES Michael Peter Kucharik, BS, UNITED STATES Christopher T Eberlin, BS, UNITED STATES Stephen M Gillinov, AB, UNITED STATES Wendy Madeline Meek, BBA, UNITED STATES Scott D Martin, MD, UNITED STATES
Superior Outcomes With Routine Capsular Repair In Hip Arthroscopy Abstract Presentation 5 minutes Austin M Looney, MD, UNITED STATES Spencer M Comfort, BS, UNITED STATES Patrick T Connolly, BS, UNITED STATES Julia E McCann, MD, UNITED STATES Andrew Curley, MD, UNITED STATES William F. Postma, MD, UNITED STATES
Hip Arthroscopy in Patients with Borderline Dysplasia. ePoster Presentation Leonel Perez Alamino, MD, ARGENTINA Daniel Fernando Veloz Serrano, Md, ARGENTINA Agustin Felipe Catan, MD, ARGENTINA Tomas Rafael Vilaseca, MD, ARGENTINA
Endoscopic Iliotibial Band Release During Hip Arthroscopy For Femoroacetabular Impingement Syndrome And External Snapping Hip Had Better Patient-Reported Outcomes: A Retrospective Comparative Study Abstract Presentation 5 minutes 春宝李, 医学博士，博士, CHINA Shanxing Zhang, MD, CHINA
Health Literacy in Periacetabular Osteotomy Procedure: A Quantitative Assessment of the Readability, Understandability and Actionability of Online Patient Education Material ePoster Presentation Alan Shamrock, MD, UNITED STATES Trevor Gulbrandsen, MD, UNITED STATES Burke Gao, MD, UNITED STATES Mary Kate Skalitzky, BA, UNITED STATES Robert W. Westermann, MD, UNITED STATES Michael C. Willey, MD, UNITED STATES
Sex- And Age-Based Differences In Outcomes And Survivorship Following Primary Hip Arthroscopy At Short And Mid-Term Follow-Up: A Comparative Analysis ePoster Presentation David R. Maldonado, MD, UNITED STATES Jade S Owens, BS, UNITED STATES Cammille Go, BA, UNITED STATES Benjamin G. Domb, MD, UNITED STATES
Assessing The Risk Of Osteoarthritis Progression And Femoral Head Collapse Following Hip Corticosteroid/Anesthetic Injection Abstract Presentation 5 minutes Paul F Abraham, BS, UNITED STATES Nathan Varady, MD, MBA, UNITED STATES Kirstin Small, MD, UNITED STATES Nehal Shah, MD, UNITED STATES Luis S Beltran, MD, UNITED STATES Michael Peter Kucharik, BS, UNITED STATES Christopher T Eberlin, BS, UNITED STATES Wendy Madeline Meek, BBA, UNITED STATES Scott D Martin, MD, UNITED STATES
Predicting Dissatisfaction Following Total Hip Arthroplasty Using A Bayesian Model Averaging (Bma) Approach: Results From The Australian Arthroplasty Clinical Outcomes Registry (Acorn) ePoster Presentation Jan Peter Van Meirhaeghe, MD, BELGIUM Rob Molnar, MBBS, AUSTRALIA Sam Adie, BSc(Med) MBBS MSpMed MPH PhD FRACS, AUSTRALIA
Does MRI Scan Enable Optimally Informed Pre-Operative Planning In Hip Arthroscopy? Abstract Presentation 5 minutes Vitali Goriainov, FRCS (Orth), BM, PhD, MSc, UNITED KINGDOM Fadi Hindi, BM, MRCS, UNITED KINGDOM Andrew Langdown, BSc MB ChB FRCS(Tr&Orth), UNITED KINGDOM
Outcomes of Proximal Hamstring Tendon Repair in Patients Older than 50 Years of Age Abstract Presentation 5 minutes Alexander Rainer Manuel Bitzer, MD, UNITED STATES Daniel Hurwit, UNITED STATES Julian Joseph Sonnenfeld, MD, UNITED STATES Durham Weeks, MD, UNITED STATES
Risk Of Conversion To Arthroplasty Following Hip Arthroscopy: Validation Of A Published Risk Score Using An Independent, Prospectively Collected Database Abstract Presentation 4 minutes Mario Hevesi, MD, PhD, UNITED STATES Devin Leland, MD, UNITED STATES Philip Joseph Rosinsky, MD, UNITED STATES Ajay C. Lall, MD, MS, FAAOS, UNITED STATES Benjamin G. Domb, MD, UNITED STATES David E. Hartigan, MD, UNITED STATES Bruce A. Levy, MD, UNITED STATES Aaron J. Krych, MD, UNITED STATES
What is the Association Between Anterior Cruciate Ligament Reconstruction and Femoroacetabular Impingement Surgery? An Analysis of Over 18,000 Hip Arthroscopies Abstract Presentation 6 minutes Clare Wise, BS , UNITED STATES Marc R. Safran, MD, Prof., UNITED STATES Jeremy N. Truntzer, MD, UNITED STATES Robin Kamal, MD, MBA , UNITED STATES

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Can Intra-Articular Gadolinium Confound The Results Of A Diagnostic Anesthetic Injection In Young Patients With Hip Pain?

Can Intra-Articular Gadolinium Confound The Results Of A Diagnostic Anesthetic Injection In Young Patients With Hip Pain?

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Methods

Results

Conclusion

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Can Intra-Articular Gadolinium Confound The Results Of A Diagnostic Anesthetic Injection In Young Patients With Hip Pain?

Can Intra-Articular Gadolinium Confound The Results Of A Diagnostic Anesthetic Injection In Young Patients With Hip Pain?

Introduction

Methods

Results

Conclusion

More ISAKOS 2021: Global Content