Anterior Impingement Test for Labral Lesions Has High Positive Predictive Value
Anterior Impingement Test for Labral Lesions Has High Positive Predictive Value
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DOI：
10.1007/s11999-012-2450-0
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发表时间：
2012-12-01
影响因子：
4.2
通讯作者：
Ohzono, Kenji
中科院分区：
文献类型：
--
作者：
Hananouchi, Takehito;Yasui, Yukihiko;Ohzono, Kenji
前撞击试验旨在检测髋臼前上盂唇病变。据报道，在接受盂唇病变治疗的患者中，其敏感性为95%至100%，在接受髋臼周围截骨术的一小群患者中，其敏感性为59%，特异性为100%。问题/目的我们研究了这四个参数（1）在髋关节疼痛的髋关节脱位患者中，和（2）在发育不良、股骨髋臼撞击（FAI）、股骨髋臼骨折（FAI）、股骨髋臼骨折（FAI）和股骨髋臼骨折（FAI）三个亚组中，方法我们前瞻性研究了69例患者（15例男性和54例女性），平均年龄57.2岁（范围，27-81岁）。一名观察员对所有患者进行了前撞击试验。我们通过放射状MRI确定了107个髋关节（38例患者双侧髋关节：14例疼痛，24例无疼痛）的前上盂唇病变的存在或不存在。我们还调查了三个亚组的参数，包括60例发育不良，27例FAI和80例完整的关节间隙;结果全髋关节4项参数的测量值分别为50.6%（45/89），88.9%（16/18），95.7%（45/47），100%（16/18），100%（16 26.7%（16/60）。三个亚组的参数是相似的所有cases.Conclusions，虽然前撞击试验的灵敏度没有达到足够的水平检测前上盂唇病变，我们相信高的阳性预测值，使测试useful.Level证据等级III，诊断研究。有关证据等级的完整描述，请参见作者指南。
Background The anterior impingement test is intended to detect anterosuperior acetabular labral lesions. In patients treated for labral lesions its sensitivity is reportedly 95% to 100%, and in a small group of patients undergoing periacetabular osteotomy, its sensitivity was 59% and specificity 100%. However, the sensitivity, specificity, positive predictive value, and negative predict value of this test to detect these labral lesions in unselected patients with hip pain are unknown.Questions/purposes We investigated these four parameters (1) in unselected patients with hip pain, and (2) in three subgroups of patients with dysplasia, femoroacetabular impingement (FAI), and with an intact joint space.Methods We prospectively studied 69 patients (15 men and 54 women) with a mean age of 57.2 years (range, 27-81 years). One observer performed the anterior impingement test in all patients. We determined the presence or absence of an anterosuperior labral lesion with radial MRI in 107 hips (38 patients in both hips: 14 with pain, and 24 without pain). We also investigated the parameters in the three subgroups which consisted of 60 cases of dysplasia, 27 cases of FAI, and 80 cases with intact joint space; the third subgroup partially overlapped the first and second subgroups.Results The four parameters in all hips were 50.6% (45/89), 88.9% (16/18), 95.7% (45/47), and 26.7% (16/60), respectively. Parameters in the three subgroups were similar to those of all cases.Conclusions Although the sensitivity of the anterior impingement test did not reach a sufficient level for detecting anterosuperior labral lesions, we believe the high positive predictive value makes the test useful.Level of Evidence Level III, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence.