Can Non-Contrast 3T MRI scans predict the type of labral procedure in hip arthroscopy?

Purpose The study proposed a simple classification system that aimed at predicting the labral procedure during hip arthroscopy using images from unenhanced 3T MRI scans. Patents and methods Forty patients undergoing hip arthroscopy had their MRI scans reviewed pre-operatively by one of two senior radiologists and classified into: type 1: stable labrum with intra-substance degeneration (no labral repair required), type 2: unstable labrum, no intra-substance degeneration (labral repair required), or type 3: unstable labrum with intra-substance degeneration (Labral repair not feasible). Hip arthroscopy is carried out by one of two surgeons and classified accordingly while blinded to the radiologists’ assessment. Results The pre-operative radiological classification managed to predict the labral procedure in 29 cases out of 40 (72.5%). The gamma value was 0.83, and the kappa value was 0.46 denoting moderate agreement. The inter-class correlation coefficient was 0.52 indicating moderate reliability. Conclusion The proposed classification showed a moderate agreement between the radiological findings and arthroscopic findings. As we cannot accurately correlate the MRI findings with the type of surgical management, the surgeon should be prepared for all scenarios of labral procedures. Level of Evidence Level IV (case series).