Demographic and Radiographic Factors Associated With Intra-articular Hip Cartilage Injury: A Cross-sectional Study of 1511 Hip Arthroscopy Procedures

Ishøi, Lasse; Thorborg, Kristian; Kraemer, Otto; Mygind-Klavsen, Bjarne; Hölmich, Per

doi:10.1177/0363546519861088

Cited by 34 publications

(36 citation statements)

References 55 publications

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“…The main findings of the research are that PROMs significantly improved in this population after surgical intervention, supporting previous literature involving both general and athletic populations. 23,34,53 The percentage of those continuing to play was also high (84%). This is comparable with other multidirectional sports such as soccer, basketball, and baseball, 24,26,43 although female patients, those with longer symptom durations, and those with lower training volumes before surgery were less likely to continue with field sports.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic Correction of Sports-Related Femoroacetabular Impingement in Competitive Athletes: 2-Year Clinical Outcome and Predictors for Achieving Minimal Clinically Important Difference

Mullins

Filan

Carton

2021

Orthopaedic Journal of Sports Medicine

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Background: A growing body of literature supports surgical intervention for femoroacetabular impingement (FAI) in young, active athletes. However, factors likely to influence results in this cohort are less clearly defined. Purpose: To quantify changes in validated patient-reported outcome measures (PROMs) and determine whether differences in baseline athlete demographic characteristics, intraoperative findings, and surgical techniques are associated with achieving improved outcomes and minimal clinically important difference (MCID) after arthroscopic management of sports-related FAI. Study Design: Case series; Level of evidence, 4. Methods: Data were prospectively collected from competitive athletes who underwent hip arthroscopy between January 2009 and February 2017. Athletes who underwent primary arthroscopic correction of sports-related FAI with labral repair were included providing they had a Tönnis grade ≤1 and a lateral center-edge angle ≥20°, excluding significant articular cartilage injury and lateral rim dysplasia. The modified Harris Hip Score, Western Ontario and McMaster Universities Osteoarthritis Index, University of California Los Angeles activity scale, and 36-Item Short Form Health Survey were used to measure outcomes at the 2-year follow-up. MCID was measured using 3 methods: a mean change method, a distribution-based method, and the percentage of possible improvement (POPI) method. Multivariate regression models were used to assess a number of diagnostic and surgical variables associated with good outcome and achieving MCID at follow-up. Results: At 2-year follow-up, statistically significant improvements were observed for all PROMs ( P < .001 for all), and 84% of athletes continued to play sport. Higher preoperative PROM scores reduced the likelihood of achieving MCID; however, returning to play was the strongest predictor of reaching MCID in this athletic cohort. Using absolute score change (mean change or distribution method) to calculate MCID was less accurate owing to ceiling effects and dependence on preoperative PROM scores. Conclusion: Athletes undergoing arthroscopy for sports-related FAI can expect a successful outcome and continued sports participation at 2 years postoperatively. The majority of athletes will achieve MCID. The POPI method of MCID calculation was more applicable to higher functioning athletic cohorts. Reduced preoperative PROM scores and the ability to return to sport increased the likelihood of achieving MCID in this population.

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Section: Discussionmentioning

confidence: 99%

Arthroscopic Correction of Sports-Related Femoroacetabular Impingement in Competitive Athletes: 2-Year Clinical Outcome and Predictors for Achieving Minimal Clinically Important Difference

Mullins

Filan

Carton

2021

Orthopaedic Journal of Sports Medicine

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“…Femoroacetabular impingement syndrome (FAIS) is a common cause of hip-related groin pain, mainly diagnosed in young and middle-aged physically active individuals. 33 FAIS is defined as a motion-related disorder of the hip joint, 11 predisposing to acetabular labral and cartilage injuries, 10,19 and end-stage osteoarthritis. 1 FAIS is often treated surgically using hip arthroscopy.…”

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confidence: 99%

How Many Patients Achieve an Acceptable Symptom State After Hip Arthroscopy for Femoroacetabular Impingement Syndrome? A Cross-sectional Study Including PASS Cutoff Values for the HAGOS and iHOT-33

Ishøi

Thorborg

Ørum

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: Hip arthroscopy is a viable treatment for femoroacetabular impingement syndrome (FAIS). Clinically relevant improvements in hip function and pain after surgery are often reported, but it is less clear how many patients achieve an acceptable symptom state (Patient Acceptable Symptom State [PASS]). Purpose: To investigate the proportion of patients who achieved a PASS 12 to 24 months after hip arthroscopy and to determine the cutoff scores of the 2 recommended and valid patient-reported outcome measures (the subscales of the Copenhagen Hip and Groin Outcome Score [HAGOS] and the International Hip Outcome Tool—33 [iHOT-33]) for which patients are most likely to achieve PASS. Study Design: Cohort study; Level of evidence, 3. Methods: Eligible study patients were identified in the Danish Hip Arthroscopy Registry. An electronic questionnaire was used to collect data on PASS, HAGOS, and iHOT-33 12 to 24 months after surgery. PASS was measured using an anchor question. Receiver operating characteristic curve analyses were applied to identify the PASS cutoff values of HAGOS and iHOT-33 scores. Results: A total of 137 individuals (mean age at surgery, 35.4 ± 9.4 years) were included in the study at a mean follow-up of 18.5 ± 3.2 months after surgery. At follow-up, 64 individuals (46.7%; 95% CI, 38.6-55.1) reported PASS. Higher HAGOS and iHOT-33 values were observed for participants who reported PASS compared with those who did not report PASS (Cohen d ≥ 1.06; P < .001). Cutoff scores for HAGOS subscales (42.5-82.5) and iHOT-33 (67.00) showed excellent to outstanding discriminative ability in predicting PASS (area under the curve, 0.82-0.92). Conclusion: In total, 46% of individuals having hip arthroscopy for FAIS achieved PASS at 12 to 24 months of follow-up. Patients who achieved PASS had statistically significant and substantially better self-reported hip function compared with those who did not achieve PASS. Cutoff values at HAGOS subscales and iHOT-33 showed excellent to outstanding discriminative ability in predicting patients with PASS.

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“…10,11,20 The advantage of fewer postoperative complications after hip arthroscopic procedures in BDDH patients has been validated in many short-to mid-term follow-up studies. [1][2][3][4][5][6][7][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] Meanwhile, it is apparent that suboptimal outcomes increase as the follow-up period increases and could reach an overall rate of 33% according to a 5-year follow-up study. 8,36 More long-term high-grade evidence is needed to analyze the impact of different characteristics of BDDH patients on their prognosis after arthroscopy to form a detailed description of which BDDH patients can achieve optimal results with arthroscopy.…”

Section: See Related Article On Page 2550mentioning

confidence: 99%

Editorial Commentary: Arthroscopy for Borderline Developmental Dysplasia of the Hip: Selection Determines the Outcomes

Ding

Chen

2020

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Although the literature has presented results that favored arthroscopic procedures in treating borderline developmental dysplasia of the hip (BDDH), it remains controversial whether arthroscopic surgery would be better than periacetabular osteotomy for BDDH. Instead of a debate on the application of arthroscopy, the issue worthy of discussion should be distinguishing suitable BDDH candidates for hip arthroscopy. First, identification of patients with real BDDH is critical for making management choices. Second, it should be distinguished whether the major symptoms result from mechanical lesions or functional hip instability. Third, once hip arthroscopy is suggested for BDDH patients, relative contraindications such as advanced age and osteoarthritis should be taken into consideration, in addition to labral repair and capsular closure or plication intraoperatively. In conclusion, more long-term and high-grade evidence is still demanded to end the debate, but we believe that an individualized management strategy based on an accurate diagnosis and comprehensive assessment will bring optimal outcomes for BDDH patients.

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Demographic and Radiographic Factors Associated With Intra-articular Hip Cartilage Injury: A Cross-sectional Study of 1511 Hip Arthroscopy Procedures

Cited by 34 publications

References 55 publications

Arthroscopic Correction of Sports-Related Femoroacetabular Impingement in Competitive Athletes: 2-Year Clinical Outcome and Predictors for Achieving Minimal Clinically Important Difference

Arthroscopic Correction of Sports-Related Femoroacetabular Impingement in Competitive Athletes: 2-Year Clinical Outcome and Predictors for Achieving Minimal Clinically Important Difference

How Many Patients Achieve an Acceptable Symptom State After Hip Arthroscopy for Femoroacetabular Impingement Syndrome? A Cross-sectional Study Including PASS Cutoff Values for the HAGOS and iHOT-33

Editorial Commentary: Arthroscopy for Borderline Developmental Dysplasia of the Hip: Selection Determines the Outcomes

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