Outcomes of Hip Arthroscopy in Patients with Tönnis Grade-2 Osteoarthritis at a Mean 2-Year Follow-up

Chandrasekaran, Sivashankar; Darwish, Nader; Gui, Chengcheng; Lodhia, Parth; Suárez-Ahedo, Carlos; Domb, Benjamin G.

doi:10.2106/jbjs.15.00644

Cited by 85 publications

(79 citation statements)

References 33 publications

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“…While FAI likely represents the most common cause of hip pain and dysfunction in young adults and an independent risk factor for early onset of HOA [5][6][7][8][9][10], relatively little is known about the events connecting the presence of FAI and the development of end-stage HOA. Moreover, although there is an initial evidence that surgical treatment of FAI may effectively improve pain and symptoms [11], there is poor information regarding the physiopathological processes that drive the HOA progression after surgical treatment of FAI [12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Labral calcification plays a key role in hip pain and symptoms in femoroacetabular impingement

et al. 2020

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Background: Hip osteoarthritis (HOA) is the most common hip disorder and a major cause of disability in the adult population, with an estimated prevalence of end-stage disease and total hip replacement. Thus, the diagnosis, prevention, and treatment of the early stages of the disease in young adults are crucial to reduce the incidence of end-stage HOA. The purpose of this study was to determine whether (1) a relationship among the inflammatory status of labrum and synovium collected from patients with femoroacetabular impingement (FAI) would exist; and (2) to investigate the associations among the histopathological features of joint tissues, the pre-operative symptoms and the postoperative outcomes after arthroscopic surgery. Methods: Joint tissues from 21 patients undergoing hip arthroscopy for FAI were collected and their histological and immunohistochemical features were correlated with clinical parameters. Results: Synovial mononuclear cell infiltration was observed in 25% of FAI patients, inversely correlated with the hip disability and osteoarthritis outcome score (HOOS) pain and function subscales and with the absolute and relative change in total HOOS. All the labral samples showed some pattern of degeneration and 67% of the samples showed calcium deposits. The total labral score was associated with increased CD68 positive cells in the synovium. The presence of labral calcifications, along with the chondral damage worsened the HOOS post-op symptoms (adjusted R-square = 0.76 p = 0.0001). Conclusions: Our study reveals a relationship between the histologic labral features, the synovial inflammation, and the cartilage condition at the time of FAI. The presence of labral calcifications, along with the cartilage damage and the synovitis negatively affects the postoperative outcomes in patients with FAI.

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Section: Introductionmentioning

confidence: 99%

Labral calcification plays a key role in hip pain and symptoms in femoroacetabular impingement

et al. 2020

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“…63 Odds ratio of conversion to THA in hips with Tönnis grade 2 was 7.73 and 4.36 times higher compared with matched cohorts of Tönnis grades 1 or 0 hips, respectively. 64 In another study, 44% of patients with Tönnis grades 2 and 3 went on to total hip replacement at mean of only 18 months after hip arthroscopy. 61 Despite the evidence that there is a higher conversion rate to THA with moderate-to-severe degrees of OA (Tönnis !…”

Section: Severity Of Preoperative Osteoarthritismentioning

confidence: 97%

Treatment of Early-Onset Hip Osteoarthritis in Young Patients

et al. 2018

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Pain and debilitating symptoms due to hip osteoarthritis (OA) can significantly compromise quality of life in young, active patients. The management of the young adult with hip OA presents a unique set of challenges, with symptoms that originate from a variety of underlying hip pathologies, and patient age spanning from youth through middle age. Early options for hip OA include nonoperative treatment with anti-inflammatory medications, physical therapy, and injections. For patients with structural hip abnormalities (femoroacetabular impingement or dysplasia), arthroscopy or reconstructive osteotomy are acceptable treatment options. In advanced disease, joint-preserving techniques are often ineffective, and patients may require joint resurfacing or replacement. The treatment strategies for early hip OA continues to evolve with the development of new and refined surgical techniques, especially in the setting of underlying hip pathology, and a growing popularity of utilizing biologic agents. The purpose of this manuscript is to review current conservative and surgical management and to describe an algorithm for treatment of early-onset hip OA.

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“…By contrast there is a general consensus that the efficacy of reconstructive hip surgery in patients with moderate joint space narrowing (i.e., Tönnis stage 2 of osteoarthritis 113 ) is limited and further decreases with age. [56][57][58]72,74,[114][115][116] In these patients the additional benefit of MR arthrography for treatment planning is doubtful, and noncontrast MRI should be considered. In patients with residual symptoms after intra-articular surgery, direct MR arthrography is recommended to assess re-tears of the labrum and capsular adhesions/defects.…”

Section: Mri Protocolmentioning

confidence: 99%

Conventional and Arthrographic Magnetic Resonance Techniques for Hip Evaluation: What the Radiologist Should Know

Schmaranzer

Cerezal

Llopis

2019

Semin Musculoskelet Radiol

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Over the last 2 decades, the definition of pathomechanical concepts that link osseous deformities to chondrolabral damage and expose young and active patients to the risk of early osteoarthritis has led to a tremendous increase in the number of joint-preserving surgeries performed. The rise in arthroscopic procedures has led to an increasing demand for comprehensive preoperative magnetic resonance imaging (MRI) assessment of the hip joint. This includes conventional MRI for the assessment of extra-articular and periarticular pathologies such as greater trochanteric pain, deep gluteal pain syndrome, and sports injuries. Magnetic resonance arthrography with or without traction is reserved for the accurate evaluation of deformities associated with impingement and hip instability and for detecting the resulting intra-articular lesions. This article summarizes the current standard imaging techniques that the radiologist should know. It also explores the potential of computer-assisted analysis of three-dimensional MRI for virtual impingement simulation and volumetric analysis of cartilage composition and geometry.

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Outcomes of Hip Arthroscopy in Patients with Tönnis Grade-2 Osteoarthritis at a Mean 2-Year Follow-up

Abstract: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Cited by 85 publications

References 33 publications

Labral calcification plays a key role in hip pain and symptoms in femoroacetabular impingement

Labral calcification plays a key role in hip pain and symptoms in femoroacetabular impingement

Treatment of Early-Onset Hip Osteoarthritis in Young Patients

Conventional and Arthrographic Magnetic Resonance Techniques for Hip Evaluation: What the Radiologist Should Know

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