Association of Radiographic Markers of Hip Instability and Worse Outcomes 2 to 4 Years After Hip Arthroscopy for Femoroacetabular Impingement in Female Patients

Marland, Jennifer D.; Horton, Brandy S.; West, Hugh S.; Wylie, James D.

doi:10.1177/03635465211073341

Cited by 9 publications

(3 citation statements)

References 29 publications

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“…Developmental dysplasia of the hip is a complex tridimensional pathology, and defining it by solely the LCEA is oversimplistic 26,54,58,59 . The anterior wall index, posterior wall index, and femoroepiphyseal acetabular roof index are radiographic markers of hip instability that were not included in this investigation 60 . Recently, the inside-out pattern of chondral damage on the acetabulum 61 , in addition to other intraoperative findings of hip instability during hip arthroscopy, was described 62 .…”

Section: Discussionmentioning

confidence: 99%

Borderline Dysplasia After Primary Hip Arthroscopy with Capsular Plication and Labral Preservation

Domb

Owens

Glein

et al. 2023

Journal of Bone and Joint Surgery

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Background: The arthroscopic management of borderline hip dysplasia (BHD) is controversial, and long-term follow-up data are scarce. The purpose of this study was to report prospectively collected survivorship and patient-reported outcome measures (PROMs) at a minimum 10-year follow-up following primary hip arthroscopy with capsular plication and labral preservation in patients with BHD.Methods: Data were prospectively collected on all patients who underwent primary hip arthroscopy between September 2008 and September 2011. Patients with BHD (defined by a lateral center-edge angle [LCEA] between 18°and 25°) were included. Preoperative and minimum 10-year follow-up scores for the modified Harris hip score (mHHS), Nonarthritic Hip Score (NAHS), Hip Outcome Score-Sports Specific Subscale (HOS-SSS), and visual analog scale (VAS) for pain were collected. Exclusion criteria were prior ipsilateral hip surgery, Workers' Compensation status, Tönnis grade of >1, previous hip conditions, or LCEA of <18°. Survivorship was defined as no conversion to total hip arthroplasty (THA). The risk factors for THA conversion were analyzed. The achievement rate for the minimal clinically important difference (MCID) was reported. A propensity-matched comparison with a control group without BHD was performed.Results: Forty-five (80%) of 56 eligible hips were included in this study: 38 hips (84%) of female patients and 7 hips (16%) of male patients. The mean patient age was 31.0 ± 12.9 years, and the mean patient body mass index (BMI) was 24.5 ± 5.4 kg/m 2 . The 10-year survivorship was 82.2%, and there was significant improvement in all PROMs and VAS pain from baseline to the minimum 10-year follow-up (p < 0.001). The odds of undergoing conversion to THA were 4.4 times higher for patients with a BMI of ‡23 kg/m 2 and 7.1 times higher for patients who were ‡42 years of age. The MCID was achieved at high rates for the mHHS (79%), NAHS (79%), HOS-SSS (70%), and VAS pain (76%). The minimum 10-year survivorship, PROMs, and MCID achievement rates for the BHD group were comparable with those for the control group.Conclusions: Patients with BHD who underwent primary hip arthroscopy with capsular plication and labral preservation demonstrated an overall survivorship of 82.2% and significant improvement in all PROMs and achieved the MCID at high rates at a minimum 10-year follow-up.

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Section: Discussionmentioning

confidence: 99%

Borderline Dysplasia After Primary Hip Arthroscopy with Capsular Plication and Labral Preservation

Domb

Owens

Glein

et al. 2023

Journal of Bone and Joint Surgery

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“…Though good clinical effects were achieved after surgery [8,9]. Many demographic factors can influence the clinical outcomes of hip arthroscopy, such as higher age, higher BMI, and female patients [10][11][12][13][14], of which obesity demonstrated a twofold increased risk of conversion to total hip arthroplasty [15].…”

Section: Introductionmentioning

confidence: 99%

Hyperlipidemia does not influence clinical outcome in arthroscopic treatment of femoroacetabular impingement syndrome

et al. 2022

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Background Cholesterol can trigger degenerative processes in the chondrocytes. The internal layer of the hip labral consists of cartilage-specific type II collagen-positive fibrocartilage. The purpose of this study was to compare outcomes after arthroscopy labral repair in FAIS patients with preoperative hyperlipidemia to a control group with no hyperlipidemia. Methods Data were prospectively collected and retrospectively reviewed for FAIS patients who had arthroscopy 2019. Patients with hyperlipidemia were 1:1 propensity-score matched to patients without hyperlipidemia. Patient-reported outcomes (HOS-ADL, iHOT-12, mHHS), VAS scores, radiographic measures, performed procedures, complications, and revision surgery were compared and analyzed for both groups. Results A total of 41 patients with hyperlipidemia and 41 patients without hyperlipidemia were found using propensity-score matching. When compared to preoperative levels, both groups demonstrated significant improvements in PROs and VAS scores at the final follow-up. Besides, there were no significant differences in preoperative scores and final outcome scores between the groups. Besides, there were no other differences in revision rate and the rate of meeting the PASS and MCID between the study and the control groups. Conclusion It was demonstrated in this study that FAIS patients with hyperlipidemia can expect to experience similar good short-term patient-reported outcomes as compared with patients without hyperlipidemia. Level of evidence Case-series study; Level of Evidence: Level III.

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“… 19 Hip dysplasia has been associated with microinstability and poor outcomes when treated with hip arthroscopy alone. 27 , 29 Periacetabular osteotomy (PAO) has demonstrated reliability and durability in treating patients with hip dysplasia at short-, mid-, and long-term follow-ups. 4 , 5 , 17 A 2019 study by Ziran et al 39 reported favorable outcomes even 20 years after surgery.…”

mentioning

confidence: 99%

Outcomes After Concomitant Hip Arthroscopy and Periacetabular Osteotomy: A Systematic Review

Lee

Fong²,

Owens

et al. 2023

Orthopaedic Journal of Sports Medicine

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Background: Despite several studies’ reports on outcomes of concomitant hip arthroscopy and periacetabular osteotomy (PAO), there is a paucity of aggregate data in the literature. Purpose: To evaluate outcomes and survivorship after concomitant hip arthroscopy and PAO. Study Design: Systematic review; Level of evidence, 4. Methods: The PubMed, Cochrane, and Scopus databases were searched in April 2022 using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The following keywords were used: (hip OR femoroacetabular impingement) AND (arthroscopy OR arthroscopic) AND (periacetabular osteotomy or rotational osteotomy) AND (outcomes OR follow-up). Of 270 articles initially identified, 10 studies were ultimately included. The following information was recorded for each study if available: publication information; study design; study period; patient characteristics; follow-up time; indications for hip arthroscopy; patient-reported outcomes (PROs); rates of secondary hip preservation surgeries; and rates of conversion to total hip arthroplasty (THA). Survivorship was defined as nonconversion to THA. Results: The study periods for the 10 included articles ranged from 2001 to 2018. Three studies were level 3 evidence, and 7 studies were level 4 evidence. This review included 553 hips with a mean follow-up of 1 to 12.8 years. All 10 studies listed dysplasia as an indication for surgery. Of 9 studies that reported PRO scores, 7 reported significant improvement after surgery. Studies with a <5-year follow-up reported conversion to THA rates of 0% to 3.4% and overall secondary surgery rates of 0% to 10.3%. Similarly, studies with >5-year follow-up reported conversion to THA rates of 0% to 3% and overall secondary surgery rates of 0% to 10%. Conclusion: Patients who underwent concomitant hip arthroscopy and PAO reported favorable outcomes, with 7 of the 9 studies that provided PRO scores indicating significant preoperative to postoperative improvement.

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Association of Radiographic Markers of Hip Instability and Worse Outcomes 2 to 4 Years After Hip Arthroscopy for Femoroacetabular Impingement in Female Patients

Cited by 9 publications

References 29 publications

Borderline Dysplasia After Primary Hip Arthroscopy with Capsular Plication and Labral Preservation

Borderline Dysplasia After Primary Hip Arthroscopy with Capsular Plication and Labral Preservation

Hyperlipidemia does not influence clinical outcome in arthroscopic treatment of femoroacetabular impingement syndrome

Outcomes After Concomitant Hip Arthroscopy and Periacetabular Osteotomy: A Systematic Review

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