EP1.3 Preoperative Quantitative Imaging Use in Predicting Intraoperative Decision for Hip Labral Repair Versus Reconstruction

Abstract Introduction: 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. Methods: This retrospective case-control study included patients with a preoperative T2 mapping MRI who underwent hip labral repair or reconstruction at a single institution between 3/2021-2/2023. Three reviewers blinded to patient information used Syngo.via software to each provide three separate sequencing analyses on each patient’s optimal T2 sagittal cut. The average T2 mapping value was recorded for the labrum and anterior, superior, and posterior acetabular and femoral head zones. Statistical analysis was stratified by age and sex, Bayseian generalized linear mixed models were constructed using the Beta coefficient to represent how the odds of needing a reconstruction change when the predictor variable is altered by 1-unit, and 95% credible intervals determined significance of regression coefficients. Results: 63 operations were included: 14 reconstructions and 49 repairs. Participants were 14-50 years-old with 35 females and 28 males. When controlling for age and sex, the odds of having a labral reconstruction were negatively associated with mapping values across all locations in a statistically significant manner (Labrum: β = -0.075, 95% CI [-0.116, -0.04]; Acetabulum: β = -0.101, 95% CI [-0.132, -0.073]; Femur: β = -0.060, 95% CI [-0.081, -0.041]). Additionally, there was a statistically significant positive association of age and the odds of needing reconstruction when controlling for the labral mapping value (β = 0.353, 95% CI [0.118, 0.635]) but not when controlling for acetabular or femoral measurements. There were no sex differences in the odds of needing reconstruction. Conclusions: T2 mapping with preoperative MRI is statistically significantly negatively associated with the odds of needing a labral reconstruction. The data revealed an additional statistically positive association between age and odds of needing a labral reconstruction when controlling for the T2 labral value. This study will allow further evaluation into anatomic and other variables that predict labral repair versus reconstruction.