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Use Of Preoperative Magnetic Resonance Imaging To Predict Clinical Outcomes Following Core Muscle Injury Repair


Matthew J. Kraeutler, MD
UNITED STATES

Use Of Preoperative Magnetic Resonance Imaging To Predict Clinical Outcomes Following Core Muscle Injury Repair

Matthew J. Kraeutler, MD, UNITED STATES Jennifer Kurowicki, MD, UNITED STATES Iciar M Davila Castrodad, MD, UNITED STATES Edward Milman, MD, UNITED STATES Toghrul Talishinskiy, MD, UNITED STATES Anthony Scillia, UNITED STATES

St. Joseph's University Medical Center, Paterson, NJ, UNITED STATES

2021 Congress   ePoster Presentation     Not yet rated

 

Anatomic Location

Hip / Groin / Thigh

Anatomic Structure

Tendon

Treatment / Technique

Repair / Reconstruction

Diagnosis / Condition

Tears

Diagnosis Method

MRI

Sports Medicine

Outcome Studies

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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.

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.

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