Factors associated with the failure of arthroscopic surgery treatment in patients with femoroacetabular impingement: A cohort study

Martínez, Diego; Gómez-Hoyos, Juan; Marquez, William H.; Gallo, Jaime

doi:10.1016/j.recote.2014.09.011

Cited by 3 publications

(1 citation statement)

References 38 publications

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“…Other factors have been associated with poor clinical outcomes after surgery, including preoperative PROs (higher Western Ontario and McMaster Universities Osteoarthritis Index and lower MHHS), patients’ characteristics (higher body mass index and workers’ compensation), and arthroscopic procedure and morphology (radiographic acetabular coverage and offset in the superior portion of the femoral neck) [8, 12, 22, 29].…”

Section: Introductionmentioning

confidence: 99%

Patients aged in their 70s do not have a high risk of progressive osteoarthritis following arthroscopic femoroacetabular impingement correction and labral preservation surgery

Honda

Utsunomiya

Hatakeyama

et al. 2019

Knee Surg Sports Traumatol Arthrosc

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Purpose The purposes of this study were to (1) evaluate the effect of age on clinical outcomes of arthroscopic femoroacetabular impingement (FAI) with labral preservation surgery and (2) identify predictors of poor postoperative clinical outcomes. Methods Eighty-four patients who underwent hip arthroscopic treatment for FAI between 2009 and 2013 were retrospectively reviewed. Patients were divided into three groups based on age. The Advanced age group consisted of patients over 70 years old, the Middle age group consisted of patients in their 50s and 60s, and the Younger age group consisted of patients less than 50 years of age. Total hip arthroplasty (THA) conversion, radiographic progression of osteoarthritis and patientreported outcomes including modified Harris Hip Score (MHHS) and Non-arthritic Hip Score (NAHS) were investigated. Results The mean follow-up period was 32.2 (range 24-60) months. THA was required in 3 patients in their 50s and 60s, which was a significantly higher rate compared to that in patients Younger than 50 years old (17% vs 0%, p = 0.036). Progression to osteoarthritis was also significantly more frequent in patients in their 50s and 60s than in patients in their 70s (50s and 60s: 33%; 70s: 0%, p = 0.030). In all age groups, the preoperative MHHS and NAHS improved at last follow-up (p < 0.001). The 50s and 60s age group [hazard ratio (HR) 6.62], preoperative mild osteoarthritic change (Tönnis grade 1, HR: 3.29) and severe cartilage damage on the acetabulum (HR: 2.63) were risk factors for progressive osteoarthritis and THA conversion. Conclusions Arthroscopic FAI correction and labral preservation surgery provide favourable clinical outcomes for patients over 70 years old in the absence of significant osteoarthritis and severe acetabular chondral damage. Patients in their 50s and 60s have a higher risk of both THA conversion and progressive osteoarthritis, while patients aged over 70 years show no evidence of progressive osteoarthritis. Chronologic age in isolation is not an absolute contra-indication to hip arthroscopy. Level of evidence III.

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Section: Introductionmentioning

confidence: 99%

Patients aged in their 70s do not have a high risk of progressive osteoarthritis following arthroscopic femoroacetabular impingement correction and labral preservation surgery

Honda

Utsunomiya

Hatakeyama

et al. 2019

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

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Predictors of Outcomes After Hip Arthroscopic Surgery for Femoroacetabular Impingement: A Systematic Review

Sogbein

Shah

Kay

et al. 2019

Orthopaedic Journal of Sports Medicine

127

111

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Background: The benefits of hip arthroscopic surgery in the setting of femoroacetabular impingement (FAI) have been well established; however, some patients may experience a greater degree of improvement than others. Identifying positive and negative predictors of outcomes would assist the orthopaedic surgeon’s management algorithm for patients with FAI. Purpose/Hypothesis: The objective of this systematic review was to identify demographic, radiographic, and other operative predictors of positive and negative outcomes after hip arthroscopic surgery for patients with FAI. It was hypothesized that factors including FAI morphology, age, body mass index (BMI), sex, dysplasia, articular cartilage damage, radiographic joint space, and labral treatment would predict outcomes after hip arthroscopic surgery. Study Design: Systematic review; Level of evidence, 4. Methods: This systematic review was performed in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Three databases (Embase, PubMed, and Ovid [MEDLINE]) were searched on May 19, 2018, using terms including “hip,” “arthroscopy,” and “FAI.” Studies were screened and data extracted in duplicate. Results: A total of 39 studies were included in this systematic review, comprising 9272 hips with a mean age of 36.5 years (47.2% female). Younger age, male sex, lower BMI (<24.5 kg/m 2 ), Tönnis grade 0, and preoperative pain relief from diagnostic intra-articular hip injections predicted positive outcomes. Female sex, older age (>45 years), longer duration of preoperative symptoms (>8 months), elevated BMI, increased Tönnis grade (≥1), chondral defects, decreased joint space (≤2 mm), increased Kellgren-Lawrence grade (>3), increased lateral center-edge angle (LCEA), and undergoing labral debridement alone were predictors of negative outcomes. Conclusion: In patients with FAI, younger age, male sex, lower BMI (<24.5 kg/m 2 ), Tönnis grade 0, and pain relief from preoperative intra-articular hip injections are significantly more likely to achieve positive outcomes after hip arthroscopic surgery. On the other hand, older age (>45 years), female sex, elevated BMI, osteoarthritic changes, decreased joint space (≤2 mm), chondral defects, increased LCEA, and undergoing labral debridement compared with labral repair are associated with negative outcomes.

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Sex-Based Differences in Outcomes After Hip Arthroscopic Surgery for Femoroacetabular Impingement: A Systematic Review

McCormack

Vopat

Rooker

et al. 2022

Orthopaedic Journal of Sports Medicine

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Background: While sex-based differences in outcomes after hip arthroscopic surgery for femoroacetabular impingement syndrome (FAIS) are often recorded, no studies have been dedicated to analyzing the literature as a whole. Purpose: To investigate whether sex is a predictor of outcomes in studies evaluating hip arthroscopic surgery for FAIS. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. We searched the PubMed, Embase, Cochrane, Ovid, and PubMed Central databases for English-language studies that evaluated sex-specific outcomes in human populations. The search terms used were as follows: (“Hip Arthroscopy”) AND (“Femoroacetabular Impingement” OR “FAI”) AND (“Sex” OR “Gender” OR “Male” OR “Female”). Studies with evidence levels 2 through 4 were included. The studies were then screened, followed by data extraction. Modified Harris Hip Score (mHHS) outcomes and return-to-sport (RTS) rates were recorded. These were analyzed using random-effects meta-analysis. Heterogeneity was calculated using the I 2 statistic. Results: Of 256 full-text articles screened, 48 articles were included in this analysis; of these, 14 studies (29%) concluded that female sex was a negative predictor of postoperative outcomes, while 6 studies (13%) found female sex to be positive predictor. The remaining 28 studies (58%) found no sex-based differences in postoperative outcomes. Of 7 studies (416 male and 519 female) included in the mHHS analysis, 2 studies concluded that male patients had significantly higher postoperative mHHS scores. Of 6 studies (502 male and 396 female) included in the RTS analysis, 1 study concluded that male patients had a significantly higher RTS rate. Conclusion: Almost one-third of the included studies determined that female sex was a negative predictor of postoperative outcomes, 13% found female sex to be a positive predictor, and 58% found no sex-based differences. Our study illustrates an insufficiency of high-level evidence supporting sex-specific differences in outcomes after hip arthroscopic surgery, but findings indicated that the postoperative mHHS score and RTS rate may be influenced by sex.

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Factors associated with the failure of arthroscopic surgery treatment in patients with femoroacetabular impingement: A cohort study

Cited by 3 publications

References 38 publications

Patients aged in their 70s do not have a high risk of progressive osteoarthritis following arthroscopic femoroacetabular impingement correction and labral preservation surgery

Patients aged in their 70s do not have a high risk of progressive osteoarthritis following arthroscopic femoroacetabular impingement correction and labral preservation surgery

Predictors of Outcomes After Hip Arthroscopic Surgery for Femoroacetabular Impingement: A Systematic Review

Sex-Based Differences in Outcomes After Hip Arthroscopic Surgery for Femoroacetabular Impingement: A Systematic Review

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