Document Type
Article
Publication Date
11-2024
Abstract
Introduction:
Hip impingement syndrome with labral tear is debilitating for young patients. When magnetic resonance arthrogram (MRA) is equivocal for surgical decision making, an additional intra-articular diagnostic injection (IA) can further confirm the diagnosis. We assessed the effectiveness on surgical decision making by combining hip MRA + IA in one single procedure.
Methods:
We conducted a retrospective review of a prospectively enrolled cohort of patients with hip impingement syndrome who underwent a combined MRA + IA procedure. A 10-mL cocktail containing 0.2% ropivacaine and Omnipaque 300 contrast media was injected into the hip joint, followed by magnetic resonance scanning, in one single outpatient procedure. Patient demographics and MRA findings were documented. Preinjection pain and immediate postinjection pain were assessed using the visual analog scale (VAS). Surgical finding under hip arthroscopy was documented in those who had positive symptomatic relief after injection.
Results:
26 patients (7 adolescent boys, 19 adolescent girls, median age 17 years) were analyzed. The VAS score improved from before injection to after injection (5.0 ± 2.6 vs. 2.2 ± 2.1, mean ± SD, P < 0.0001). 1 patient reported no postinjection improvement and had no labral tear identified under hip arthroscopy; all the other 25 patients reported postinjection improvement and had labral tears repaired under hip arthroscopy; 4 among these 25 had negative MRA findings. The average Cam lesion alpha angle was 63.4 ± 7.1°.
Conclusions:
Combined hip MRA + IA is effective for surgical decision making. One single injection procedure is efficient for both patients and surgeons by eliminating an additional visit and saving costs and lead time for surgical decision making. Avoiding a second needle insertion is also preferable among pediatric and adolescent patients.
Recommended Citation
Sarna, Neil; Onor, Gabriel I.; Schenker, Kathleen E.; and Su, Alvin W., "Combined Single-Shot Intra-Articular Injection of Ropivacaine and Contrast Media for Magnetic Resonance Imaging: Surgical Decision Making for Hip Arthroscopy in Young Patients" (2024). Rothman Institute Faculty Papers. Paper 285.
https://jdc.jefferson.edu/rothman_institute/285
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License
Language
English
Comments
This article is the author’s final published version in the Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews, Volume 18, Issue 11, November 2024, Article number e24.00305.
The published version is available at https://doi.org/10.5435/JAAOSGlobal-D-24-00305. Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Orthopaedic Surgeons.