Preoperative quantitative imaging use in predicting intraoperative decision for hip labral repair versus reconstruction

Intraoperative assessment of labral quality determines arthroscopic repair versus reconstruction for hip labral tear treatment. T2 mapping technology discriminates between healthy and damaged cartilage. This study investigated if T2 mapping magnetic resonance imaging (MRI) can preoperatively predict labral repair versus reconstruction. This retrospective comparative study included patients with preoperative T2 mapping MRI who underwent hip labral repair or reconstruction at a single institution between March 2021 and February 2023. Three reviewers using Syngo.via recorded average T2 mapping values for the labrum, acetabular cartilage, and femoral cartilage on patients' sagittal cut. Intraclass correlation values estimated rater agreement of T2 values. T2 means were compared using <i>t</i>-tests. Three Bayesian regression models were created, separately analyzing the labrum, acetabular cartilage, and femoral cartilage mapping values. The 95% credible intervals determined the significance of regression coefficients. A total of 63 operations were included: 14 reconstructions and 49 repairs. Participants were 14- to 50-years-old, with 35 females and 28 males. There was excellent agreement among raters for T2 measurements. There was no significant difference in average T2 values between the repair and reconstruction groups. All three models showed that the odds of labral reconstruction were negatively associated with T2 mapping values, positively associated with age, and increased in males. Preoperative T2 mapping values from the labrum, acetabular, and femoral cartilage are negatively associated with the odds of needing a labral reconstruction. Increased age and being male are associated with increased odds of needing a labral reconstruction. This study will allow further evaluation into other variables that predict labral repair versus reconstruction.