Hip disability and osteoarthritis outcome scoreAn extension of the Western Ontario and McMaster Universities Osteoarthritis Index

Klässbo, Maria; Larsson, Eva; Mannevik, Eva

doi:10.1080/03009740310000409

Cited by 388 publications

(330 citation statements)

References 9 publications

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“…The HOOS is a validated PRO that more precisely captures hip dysfunction in patients with and without underlying osteoarthritis [13,14]. PROs indicated no difference between groups preoperatively (HOOS subscales [ Table 4]: symptoms p = 0.96, pain p = 0.83, activities of daily living 0.769, and quality of life 0.879); SF-12 physical [ Table 5]: p = 0.93; UCLA activity [ Table 5], p = 0.76).…”

Section: Methodsmentioning

confidence: 99%

“…The radiographic correction achieved was smaller in patients who had undergone prior pelvic osteotomy surgery than in patients undergoing PAO without prior pelvic surgery. With revision PAOs, the mean correction attained was 19°for LCEA (p \ 0.001, SD 10°; 95% CI, 14-24), 13°for ACEA (p = 0.014, SD 12°; 95% CI, [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20], and À12°for AI (p \ 0.001, SD 9°; 95% CI, À20 to À15) ( Table 3). In comparison, the mean correction attained in the primary cohort was 22°in LCEA (p \ 0.001, SD 10°; 95% CI, 20-26), À17°for AI (p \ 0.001, SD 6°; 95% CI, À16 to À6), and 24°for ACEA (p \ 0.001, SD 12°; 95% CI, [19][20][21][22][23][24][25][26][27][28][29].…”

Section: Methodsmentioning

confidence: 99%

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Does Previous Pelvic Osteotomy Compromise the Results of Periacetabular Osteotomy Surgery?

Stambough

Clohisy

Baca

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background As the Bernese periacetabular osteotomy (PAO) has grown in popularity, specific indications and the results in patients treated for those indications need to be evaluated. Currently, although many patients undergo PAO after having had prior pelvic osteotomy, there is limited information regarding the efficacy of the PAO in these patients.Questions/purposes The purpose of this study was to compare the (1) early pain, function, activity, and quality of life outcomes; (2) radiographic correction; and (3) major complications and failures between patients who underwent PAO after prior pelvic reconstruction versus those who had a PAO without prior surgery. Methods Between February 2008 and January 2012, 39 patients underwent PAO after prior pelvic osteotomy at one of 11 centers and were entered into a collaborative multicenter database. Of those, 34 (87%) were available for followup at a mean of 2.5 years (range 1-5 years). This group was compared with a matched group of 78 subjects, of whom 71 (91%) were available for followup at a similar interval. We compared clinical outcomes including UCLA activity score, SF-12, and Hip Disability and Osteoarthritis Outcome Score (HOOS); radiographic measures-anterior and lateral center-edge angle and acetabular inclination (AI)-and reoperations, major complications, and conversions to total hip arthroplasty. CI,) than the primary cohort. The revision cohort achieved a smaller average radiographic correction than in patients undergoing PAO without prior pelvic surgery. The mean correction in AI was less dramatic when directly comparing the revision and comparison groups (À12°to À17°, p\ 0.001, SD 2.3-8.5). Although there was no difference in severe complications requiring further surgery, there were two conversions to hip arthroplasty (p = 0.109; 95% CI, 0.004-2.042) in the study group. Conclusions PAO performed after prior pelvic surgery is associated with improvements in pain, function, radiographic correction, and early complication rates, but the improvements observed at short-term followup were smaller and more variable than those seen in patients who had not undergone prior pelvic surgery. We recommend considering PAO for residual deformities after prior osteotomy to improve function and quality life but warning patients of potential ceiling effects with a second periacetabular surgery. Level of Evidence Level III, therapeutic study.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Does Previous Pelvic Osteotomy Compromise the Results of Periacetabular Osteotomy Surgery?

Stambough

Clohisy

Baca

et al. 2015

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…Isolated hardware removal was not included in the number of previous surgeries. Baseline clinical scores included modified Harris hip score (mHHS) [9], WOMAC [1,12], and SF-12 [19] scores. Patients were subclassified into five categories based on surgeon-assigned diagnoses (at the time of secondary surgery) and type of previous and secondary surgery including (1) FAI/labral tears; (2) adult hip dysplasia; (3) pediatric hip dysplasia; (4) SCFE; and (5) LCP disease/residual Perthes-like deformities (Fig.…”

Section: Methodsmentioning

confidence: 99%

Persistent Structural Disease Is the Most Common Cause of Repeat Hip Preservation Surgery

Clohisy

Nepple

Larson

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Hip preservation surgery has become more commonplace, yet when it fails, it is unclear why it does so. Understanding failed procedures should lead to improved surgical results. Questions/purposes The purposes of this study were to (1) characterize patients undergoing hip preservation surgery after prior procedures; (2) compare demographics, hip pain, and function in patients with prior procedures with those undergoing primary surgery; (3) determine the types of previous procedures and the reasons for secondary surgery; and (4) report the procedure profile of the secondary surgeries. Methods A prospective, multicenter hip preservation database of 2263 patients (2386 surgery cases) was reviewed to identify 352 patients (359 hips, 15% of the total) who had prior surgery. Patient demographics, type of previous surgery, diagnostic categories, clinical scores, and type of secondary procedure were recorded.

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“…The mean Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) 24 increased by 9.6 at final follow-up (p < 0.001), with no complications. Leunig et al 25 reported three cases of mild SCFE (slip angle between 15°a nd 30°) in patients aged between 11 and 15 years treated with arthroscopic osteochondroplasty followed by in situ pinning concomitantly.…”

Section: Figmentioning

confidence: 99%

Surgical treatment of femoroacetabular impingement in patients with slipped capital femoral epiphysis

Azegami

Kosuge

Ramachandran

2013

The Bone & Joint Journal

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Slipped capital femoral epiphysis (SCFE) is relatively common in adolescents and results in a complex deformity of the hip that can lead to femoroacetabular impingement (FAI). FAI may be symptomatic and lead to the premature development of osteoarthritis (OA) of the hip. Current techniques for managing the deformity include arthroscopic femoral neck osteochondroplasty, an arthroscopically assisted limited anterior approach to the hip, surgical dislocation, and proximal femoral osteotomy. Although not a routine procedure to treat FAI secondary to SCFE deformity, peri-acetabular osteotomy has been successfully used to treat FAI caused by acetabular over-coverage. These procedures should be considered for patients with symptoms due to a deformity of the hip secondary to SCFE. Slipped capital femoral epiphysis (SCFE) is the most common adolescent disorder of the hip and the incidence is likely to increase, given the current epidemic of obesity in childhood. 1,2 It has been reported that the age at onset decreases with increasing obesity. 3 SCFE creates a complex deformity of the hip that can result in femoroacetabular impingement (FAI), which may lead to the early development of osteoarthritis (OA) of the hip. 4 Retrospective studies of patients with untreated SCFE and of pinning in situ without realignment suggest that the severity of the slip correlates with the subsequent radiological evidence of OA and poor clinical outcome scores, but is not necessarily predictive of FAI. 5,6 In a retrospective study by Dodds et al, 6 32% of patients (16 of 49) who previously presented to their institution with SCFE were found to have clinical signs of FAI.In situ pinning is commonly undertaken and is a relatively low risk procedure relying on remodelling of the proximal femur. However, it may still result in radiological osteoarthritic changes and a poor clinical outcome. Surgical management of FAI is aimed at restoring a more normal femoral head-neck offset in order to increase clearance and prevent femoral abutment against the acetabular edge. Various management strategies have been described, including arthroscopic osteochondroplasty, arthroscopically assisted osteochondroplasty via arthrotomy, surgical dislocation osteochondroplasty, proximal femoral osteotomy and peri-acetabular osteotomy. PathophysiologyBased on the type of abnormal morphology, FAI can be divided into three types: cam, pincer, and mixed-type. 4 In cam-type impingement the prominent area, typically on the anterolateral femoral neck, abuts the acetabular rim during forceful movement, especially in flexion and internal rotation, leading to damage of the labral-chondral complex. 7 In pincertype impingement the abnormality is on the acetabular side, involving focal or global overcoverage of the femoral head leading to damage of the femoral head-neck region and labrum. 8,9 FAI can also be classified as primary and secondary (Fig. 1).In SCFE, the relative positioning of the femoral head leads to prominence of the anterolateral femoral metaphysis (Fig. 2). 10 Th...

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Hip disability and osteoarthritis outcome scoreAn extension of the Western Ontario and McMaster Universities Osteoarthritis Index

Cited by 388 publications

References 9 publications

Does Previous Pelvic Osteotomy Compromise the Results of Periacetabular Osteotomy Surgery?

Does Previous Pelvic Osteotomy Compromise the Results of Periacetabular Osteotomy Surgery?

Persistent Structural Disease Is the Most Common Cause of Repeat Hip Preservation Surgery

Surgical treatment of femoroacetabular impingement in patients with slipped capital femoral epiphysis

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