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Alvero AB, Wright-Chisem J, Vogel MJ, Wright-Chisem A, Mather RC, Nho SJ. Treatment of Hip Cartilage Defects in Athletes. Sports Med Arthrosc Rev 2024; 32:95-103. [PMID: 38978203 DOI: 10.1097/jsa.0000000000000378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
Chondral defects in the athlete's hip are a relatively common occurrence, often presenting with debilitating pain and activity limitation. Preoperative identification of cartilage defects is challenging and there are many different modalities for treatment. Nonsurgical interventions, including activity modification, physical therapy, and injections, play a vital role, especially in less severe cases and as adjuncts to surgical intervention. Treating surgeons must be familiar with the cartilage restoration procedures available, including debridement, microfracture, and various implantation and transplantation options. Safe and effective management of cartilage defects is imperative to an athlete's return to sport. It is also imperative that surgeons are aware of all these various treatment options to determine what modality is best for their patients. This review serves to outline these options, cover the published literature, and provide general guidelines for surgeons when they encounter chondral defects in the office and the operating room.
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Affiliation(s)
- Alexander B Alvero
- Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopedic Surgery, Rush Medical College of Rush University, Rush University Medical Center; Chicago, IL
| | - Joshua Wright-Chisem
- Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopedic Surgery, Rush Medical College of Rush University, Rush University Medical Center; Chicago, IL
| | - Michael J Vogel
- Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopedic Surgery, Rush Medical College of Rush University, Rush University Medical Center; Chicago, IL
| | - Adam Wright-Chisem
- Department of Orthopedic Surgery, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Richard C Mather
- Department of Orthopedic Surgery, Duke University Medical Center, Durham, NC
| | - Shane J Nho
- Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopedic Surgery, Rush Medical College of Rush University, Rush University Medical Center; Chicago, IL
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Dove JH, Laperche J, Schiller J, Tabaddor R, Cohen E. Older age and smaller joint space width are associated with conversion to total hip arthroplasty following hip arthroscopy. J Orthop 2023; 46:174-177. [PMID: 38031628 PMCID: PMC10682505 DOI: 10.1016/j.jor.2023.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 11/03/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose The goal of this study was to define the outcomes of patients following hip arthroscopy and to identify potential factors, found during hip arthroscopy, that were associated with patients' eventual conversion to total hip arthroplasty (THA). Methods Patients who had undergone hip arthroscopy from January 2010 to January 2015 were retrospectively reviewed and patients were reported if they had a THA in the same hip. Patients were followed up to December 2022 resulting in between 7 and 12 years of follow-up. Measures from the hip scope including joint space width and cartilage grades were reported. Differences in these measures and demographics were compared between patients who had THA after hip arthroscopy and those who did not with T-tests. Results Patients who had hip arthroscopy and were then converted to THA were significantly older than those patients who did not have THA (50.3 vs 42.0 years) (p = 0.039). The average time of conversion to THA from index hip arthroscopy was 3.59 years with a range of 0.48-8.91 years. Joint space width in patients converted to THA was significantly less, 3.08 mm ± 1.93 mm, compared to non-THA converted patients, 3.62 mm ± 0.88 mm (p < 0.001). Conclusions Older age and smaller joint space width of the hip was associated with patients who were converted to THA following hip arthroscopy. Level of evidence Level III.
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Affiliation(s)
- James H. Dove
- Brown University Department of Orthopedics, Providence, RI, USA
| | - Jacob Laperche
- Frank H. Netter School of Medicine Quinnipiac University, North Haven, CT, USA
- University Orthopedics, East Providence, RI, USA
| | - Jonathan Schiller
- Brown University Department of Orthopedics, Providence, RI, USA
- University Orthopedics, East Providence, RI, USA
| | - Ramin Tabaddor
- Brown University Department of Orthopedics, Providence, RI, USA
- University Orthopedics, East Providence, RI, USA
| | - Eric Cohen
- Brown University Department of Orthopedics, Providence, RI, USA
- University Orthopedics, East Providence, RI, USA
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Ruzbarsky JJ, Comfort SM, Lee S, Pierpoint LA, Philippon MJ. The Relationship Between the Joint Space and Outcomes After Hip Arthroscopic Surgery for Femoroacetabular Impingement: Reevaluating the 2-mm Rule. Am J Sports Med 2023; 51:1538-1547. [PMID: 37067829 DOI: 10.1177/03635465231161372] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
BACKGROUND A limited joint space (<2 mm) is associated with poorer outcomes and conversion to total hip arthroplasty (THA) after hip arthroscopic surgery. As indications for hip arthroscopic surgery expand, it is important to reevaluate established risk factors among large patient populations. PURPOSE To reevaluate the relationship between the radiographic joint space and outcomes after hip arthroscopic surgery and to assess the validity of a joint space of 2 mm as the accepted cutoff for successful hip arthroscopic surgery. STUDY DESIGN Cohort study; Level of evidence, 3. METHODS Patients aged 18 to 50 years who underwent hip arthroscopic surgery for femoroacetabular impingement between January 2008 and December 2016 and had a minimum 2-year follow-up were included. Patients with previous ipsilateral hip surgery, a history of hip fractures, dysplasia (lateral center-edge angle <20°), or osteoarthritis (Tonnis grade >2) were excluded. The joint space was categorized as diminished (≤2 mm), borderline (>2 to ≤3 mm), or preserved (>3 mm). Minimum 2-year patient-reported outcomes (modified Harris Hip Score [mHHS], Hip Outcome Score-Activities of Daily Living [HOS-ADL], Hip Outcome Score-Sports-Specific Subscale [HOS-SSS]), revision rates, and rates of conversion to THA were compared between groups. RESULTS A total of 699 patients (782 hips) with a mean age of 33.8 ± 10.1 years met 2-year inclusion criteria. The mean follow-up time was 4.2 ± 2.1 years. Overall, 51 hips (6.5%) had a diminished joint space, 297 (38.0%) had a borderline joint space, and 434 (55.5%) had a preserved joint space. Patients with a diminished joint space had larger femoral and acetabular defects compared with those with larger joint spaces. All groups had improved patient-reported outcome scores compared with baseline (P < .001 for all), and there were no differences between the groups in the percentage of patients who reached the minimal clinically important difference or patient acceptable symptom state. There were also no differences between the groups in revision rates (P = .95). A greater number of hips with a diminished joint space converted to THA (n = 8 [15.7%]) compared with those with a borderline (n = 9 [3.0%]) or preserved (n = 9 [2.1%]) joint space (P < .001). Considering joint space as a continuous variable, adjusted logistic regression showed that for every millimeter decrease in the joint space, the odds of conversion to THA increased by a factor of 2.5 (odds ratio, 2.5 [95% CI, 1.6-3.8]). CONCLUSION This study demonstrated that patients with a diminished joint space were at a higher risk of conversion to THA. Although 2 mm should not serve as a strict cutoff, patients should be counseled based on their preoperative radiographic findings accordingly.
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Affiliation(s)
- Joseph J Ruzbarsky
- Steadman Philippon Research Institute, Vail, Colorado, USA
- The Steadman Clinic, Vail, Colorado, USA
| | | | - Simon Lee
- Steadman Philippon Research Institute, Vail, Colorado, USA
- The Steadman Clinic, Vail, Colorado, USA
| | | | - Marc J Philippon
- Steadman Philippon Research Institute, Vail, Colorado, USA
- The Steadman Clinic, Vail, Colorado, USA
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Rosinsky PJ, Chen JW, Glein RM, Jimenez AE, Brayboy C, Domb BG. Lateral to Medial Joint Space Ratio is Predictive of Survivorship After Primary Hip Arthroscopy. Arthroscopy 2023; 39:300-307. [PMID: 35810975 DOI: 10.1016/j.arthro.2022.06.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 06/13/2022] [Accepted: 06/23/2022] [Indexed: 02/02/2023]
Abstract
PURPOSE To assess whether preoperative joint space measures would be predictive of survivorship in patients undergoing hip arthroscopy (HA) for femoroacetabular impingement (FAI). METHODS Data on consecutive patients who underwent hip arthroscopy between February 2008 and February 2018 were retrospectively reviewed. To be eligible for final analysis, patients were required to have preoperative radiographs for joint space measurements and data indicating conversion to a total hip arthroplasty (THA), hip resurfacing, or neither; at a minimum of 2 years after primary hip arthroscopy. Survivorship following HA was defined as remaining conversion free and served as the primary outcome. A multivariate logistic regression analysis and receiver operator curve (ROC) were used to evaluate the correlation between joint space measurements and survivorship following HA. RESULTS A total of 1,885 primary arthroscopy cases were included in this study. The multivariate regression analysis found preoperative lateral-to-medial joint space ratio (L/M ratio) to be the strongest predictive factor of survivorship after primary hip arthroscopy (OR = 2.084, CI95% = 1.239-3.503; P = .006). The ROC curve for the model demonstrated acceptable discrimination with an area under the curve (AUC) of 0.792. Patients with an L/M ratio ≥0.75 had a survivorship rate of 91.7% compared to a rate of 75% for patients with an L/M ratio <0.75 (OR: 3.68). CONCLUSIONS This study found that, of the factors evaluated in this study, the most significant factor in predicting survivorship at 2 years after undergoing primary hip arthroscopy was a larger lateral-to-medial joint space ratio. This may suggest an initiation of primary arthritis at the edge-loading area of the lateral acetabulum. LEVEL OF EVIDENCE: III, retrospective comparative observation study.
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Affiliation(s)
- Philip J Rosinsky
- American Hip Institute Research Foundation, Chicago, Illinois, U.S.A
| | - Jeffrey W Chen
- American Hip Institute Research Foundation, Chicago, Illinois, U.S.A
| | - Rachel M Glein
- American Hip Institute Research Foundation, Chicago, Illinois, U.S.A
| | - Andrew E Jimenez
- American Hip Institute Research Foundation, Chicago, Illinois, U.S.A
| | - Ciaran Brayboy
- American Hip Institute Research Foundation, Chicago, Illinois, U.S.A
| | - Benjamin G Domb
- American Hip Institute Research Foundation, Chicago, Illinois, U.S.A; American Hip Institute, Chicago, Illinois, U.S.A..
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Owens JS, Saks BR, Miecznikowski KB, Maldonado DR, Jimenez AE, Lall AC, Domb BG. It's not arthritis! Resolution of the illusion of joint space narrowing with acetabuloplasty and labral reconstruction for the calcified labrum. J Hip Preserv Surg 2022; 9:232-239. [PMID: 36908559 PMCID: PMC9993452 DOI: 10.1093/jhps/hnac044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 08/02/2022] [Accepted: 08/25/2022] [Indexed: 03/14/2023] Open
Abstract
Labral calcification may be part of the natural history of untreated femoroacetabular impingement syndrome (FAIS) in certain patients, making it a potential target for intervention with the goal of preserving the hip joint. The purpose of this study was to investigate if calcified labra create the appearance of lateral joint space narrowing and report minimum 2-year patient-reported outcome measures (PROMs) after treating patients with arthroscopic acetabuloplasty and labral reconstruction. Prospectively collected data on patients who underwent primary hip arthroscopy for FAIS and labral tearing from February 2015 to April 2021 were reviewed. Patients treated with primary labral reconstruction for an intraoperatively confirmed diagnosis of labral calcification were included. A sub-analysis was performed for patients with a minimum of 2-year follow-up. Preoperative and postoperative PROMs for the modified Harris hip score, nonarthritic hip score, the International Hip Outcome Tool-12 and visual analog scale for pain were recorded. Forty-six hips (46 patients) were included, with 19 hips in the sub-analysis. There was a significant increase in apparent lateral joint space width (JSW) measured on supine anteroposterior (AP) pelvis radiographs with no significant changes in medial and central JSW and significant decreases in the lateral and anterior center-edge angles and alpha angle. Patients experienced significant increases in PROMs and high rates of achieving psychometric thresholds. Patients presenting with FAIS and calcified labra may have apparent lateral joint space narrowing on pre-operative supine AP pelvis radiographs. These patients have low rates of full-thickness femoral head and acetabular cartilage pathology, this apparent narrowing can be corrected and excellent outcomes and survivorship can be achieved, with primary labral reconstruction.
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Affiliation(s)
- Jade S Owens
- American Hip Institute Research Foundation, 999 E Touhy Ave Des Plaines, Chicago, IL 60018, USA
| | - Benjamin R Saks
- American Hip Institute Research Foundation, 999 E Touhy Ave Des Plaines, Chicago, IL 60018, USA
| | - Kara B Miecznikowski
- American Hip Institute Research Foundation, 999 E Touhy Ave Des Plaines, Chicago, IL 60018, USA
| | - David R Maldonado
- American Hip Institute Research Foundation, 999 E Touhy Ave Des Plaines, Chicago, IL 60018, USA
| | - Andrew E Jimenez
- American Hip Institute Research Foundation, 999 E Touhy Ave Des Plaines, Chicago, IL 60018, USA
| | - Ajay C Lall
- American Hip Institute Research Foundation, 999 E Touhy Ave Des Plaines, Chicago, IL 60018, USA.,American Hip Institute, 999 E Touhy Ave Des Plaines, Chicago, IL 60018, USA
| | - Benjamin G Domb
- American Hip Institute Research Foundation, 999 E Touhy Ave Des Plaines, Chicago, IL 60018, USA.,American Hip Institute, 999 E Touhy Ave Des Plaines, Chicago, IL 60018, USA
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Domb BG, Ouyang VW, Go CC, Gornbein JA, Shapira J, Meghpara MB, Maldonado DR, Lall AC, Rosinsky PJ. Personalized Medicine Using Predictive Analytics: A Machine Learning-Based Prognostic Model for Patients Undergoing Hip Arthroscopy. Am J Sports Med 2022; 50:1900-1908. [PMID: 35536218 DOI: 10.1177/03635465221091847] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Personalized medicine models to predict outcomes of orthopaedic surgery are scarce. Many have required data that are only available postoperatively, mitigating their usefulness in preoperative decision making. PURPOSE To establish a method for predictive modeling to enable individualized prognostication and shared decision making based on preoperative patient factors using data from a prospective hip preservation registry. STUDY DESIGN Cohort study (Prognosis); Level of evidence, 2. METHODS Preoperative data of 2415 patients undergoing hip arthroscopy for femoroacetabular impingement syndrome between February 2008 and November 2017 were retrospectively analyzed. Two machine-learning analyses were evaluated: Tree-structured survival analysis (TSSA) and Cox proportional hazards modeling for predicting time to event and for computing hazard ratios for survivorship after hip arthroscopy. The Fine-Gray model was similarly used for repeat hip arthroscopy. Variables were selected for inclusion using the minimum Akaike Information Criterion (AIC). The stepwise selection was used for the Cox and Fine-Gray models. A web-based calculator was created based on the final models. RESULTS Prognostic models were successfully created using Cox proportional hazards modeling and Fine-Gray models for survivorship and repeat hip arthroscopy, respectively. The Harrell C-statistics of the Cox model calculators for survivorship after hip arthroscopy and the Fine-Gray model for repeat hip arthroscopy were 0.848 and 0.662, respectively. Using the AIC, 13 preoperative variables were identified as predictors of survivorship, and 6 variables were identified as predictors for repeat hip arthroscopy. In contrast, the TSSA model performed poorly, resulting in a Harrell C-statistic <0.6, rendering it inaccurate and not interpretable. A web-based calculator was created based on these models. CONCLUSION This study successfully created an institution-specific machine learning-based prognostic model for predictive analytics in patients undergoing hip arthroscopy. Prognostic models to predict survivorship and the need for repeat surgeries were both adapted into web-based tools to assist the physician with shared decision making. This prognostic model may be useful at other institutions after performing external validation. Additionally, this study may serve as proof of concept for a methodology for the development of patient-specific prognostic models. This methodology may be used to create other predictive analytics models in different realms of orthopaedic surgery, contributing to the evolution from evidence-based medicine to personalized medicine.
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Affiliation(s)
- Benjamin G Domb
- American Hip Institute Research Foundation, Chicago, Illinois, USA.,American Hip Institute, Chicago, Illinois, USA
| | - Vivian W Ouyang
- American Hip Institute Research Foundation, Chicago, Illinois, USA
| | - Cammille C Go
- American Hip Institute Research Foundation, Chicago, Illinois, USA
| | - Jeffrey A Gornbein
- Department of Medicine Statistics Core, University of California, Los Angeles, California, USA
| | - Jacob Shapira
- American Hip Institute Research Foundation, Chicago, Illinois, USA
| | | | | | - Ajay C Lall
- American Hip Institute Research Foundation, Chicago, Illinois, USA
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Rosinsky PJ, Diulus SC, Walsh JP, Meghpara MB, Shapira J, Maldonado DR, Lall AC, Kyin C, Domb BG. Development of a Predictive Algorithm for Symptomatic Hip Abductor Tears in Patients Undergoing Primary Hip Arthroscopy. Am J Sports Med 2021; 49:497-504. [PMID: 33405942 DOI: 10.1177/0363546520980461] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Patients presenting with lateral hip pain may pose a difficult diagnostic challenge, as pain can be due to various causes. PURPOSE/HYPOTHESIS The purpose was to identify risk factors and predictors for symptomatic hip abductor tears in a cohort of patients undergoing primary hip arthroscopy for femoroacetabular impingement syndrome. We hypothesized that body mass index (BMI), female sex, age, and presence of chondral damage would be significant predictors of hip abductor pathologies. STUDY DESIGN Cohort study (diagnosis); Level of evidence, 3. METHODS Data were prospectively collected and retrospectively reviewed. Patients were included if they underwent primary hip arthroscopy between March 2009 and December 2019. Patients with Tönnis grade >1, previous hip conditions, incomplete radiographic data, or open procedures were excluded. All demographic variables, intraoperative measurements, and radiographic measurements were assessed using a bivariate analysis. A stepwise logistic regression was used to determine predictive variables. RESULTS In total, 255 hips with a hip abductor tear that underwent hip arthroscopy and 2106 hips without a tear that underwent hip arthroscopy were included. The stepwise logistic regression successfully created a predictive model using age, sex, BMI, lateral joint space, and alpha angle as variables. The efficiency of the predictive model was 90.7%, with an area under the curve of 0.894. The odds of having a hip abductor tear were 7.41 times higher in females (odds ratio [OR], 7.41; 95% CI, 4.61-11.9). Each additional year of age was associated with a 13.7% (OR, 1.137; 95% CI, 1.12-1.16) increase in the odds of having a tear. Similarly, with each 1-unit increase in BMI, the odds of having a tear increased by 3.4% (OR, 1.034; 95% CI, 1.01-1.06). CONCLUSION This study successfully created a predictive model that identified female sex (OR, 7.41), increasing age (OR, 1.137 for each year), and increased BMI (OR, 1.034 for each unit of BMI) as significant independent predictors of the presence of hip abductor tears in patients undergoing hip arthroscopy for femoroacetabular impingement syndrome. This model can be used in support of physical examination and imaging suggestive of hip abductor pathology to preoperatively identify the probability of a symptomatic hip abductor tear in these patients.
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Affiliation(s)
| | | | | | - Mitchell B Meghpara
- American Hip Institute Research Foundation, Chicago, Illinois, USA.,AMITA Health St Alexius Medical Center, Hoffman Estates, Illinois, USA
| | - Jacob Shapira
- American Hip Institute Research Foundation, Chicago, Illinois, USA
| | | | - Ajay C Lall
- American Hip Institute Research Foundation, Chicago, Illinois, USA.,American Hip Institute, Chicago, Illinois, USA
| | - Cynthia Kyin
- American Hip Institute Research Foundation, Chicago, Illinois, USA
| | - Benjamin G Domb
- American Hip Institute Research Foundation, Chicago, Illinois, USA.,American Hip Institute, Chicago, Illinois, USA
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Maldonado DR, Diulus SC, Shapira J, Rosinsky PJ, Kyin C, Ankem HK, Lall AC, Domb BG. Hip Arthroscopic Surgery in the Context of Femoroacetabular Impingement Syndrome, Labral Tear, and Acetabular Overcoverage: Minimum 5-Year Outcomes With a Subanalysis Against Patients Without Overcoverage. Am J Sports Med 2021; 49:55-65. [PMID: 33237818 DOI: 10.1177/0363546520969985] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Improvement in patient-reported outcomes (PROs) has been reported in the short term after hip arthroscopy for femoroacetabular impingement syndrome (FAIS) and labral tear in the setting of acetabular overcoverage. Yet, there is a paucity of information in the literature on midterm PROs. PURPOSE To (1) report minimum 5-year PROs in patients who underwent primary hip arthroscopy for FAIS and acetabular labral tears in the context of acetabular overcoverage and (2) compare outcomes with those of a propensity-matched control group without acetabular overcoverage. STUDY DESIGN Cohort study; Level of evidence, 3. METHODS Data were prospectively collected and retrospectively analyzed on all patients who underwent hip arthroscopy for FAIS and labral tears between February 2008 and November 2013. Inclusion criteria were lateral center-edge angle >40° and minimum 5-year follow-up for the modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), and the Hip Outcome Score-Sports-Specific Subscale (HOS-SSS). Exclusion criteria were previous ipsilateral hip surgery or conditions, active workers' compensation claims, or lack of minimum 5-year outcomes. A 1:1 propensity-matched comparison was made between the study group and a control group without acetabular overcoverage (lateral center-edge angle, 25°-40°) based on age at surgery, sex, body mass index, Tönnis grade, laterality, and follow-up time. The minimal clinically important difference (MCID) was calculated for the mHHS, HOS-SSS, and NAHS. Secondary surgical procedures were recorded. RESULTS A total of 54 patients satisfied the inclusion criteria for the study group, of whom 45 (83.3%; 45 hips) had a minimum 5-year follow-up and were matched without differences in age at surgery, sex, body mass index, or follow-up time. The study and control groups demonstrated significant and comparable improvements for the mHHS (mean ± SD Δ, 24.06 ± 24.19 vs 26.33 ± 17.27; P = .625), NAHS (Δ, 31.22 ± 25.31 vs 27.15 ± 17.61; P = .399), and HOS-SSS (Δ, 33.16 ± 34.73 vs 34.75 ± 26.15; P = .557). The rates for achieving the MCID were similar for the study and control groups for the mHHS (76.7% vs 84.2%; P = .399), HOS-SSS (79.1% vs 75.8%; P = .731), and NAHS (81.4% vs 84.2%; P = .738). Need for revision surgery was similar (P = .748). A lower conversion rate to total hip arthroplasty was reported for the study than for the control group (2.2% vs 15.6%; P = .026). CONCLUSION In the context of FAIS, labral tears, and acetabular overcoverage, patients who underwent hip arthroscopy reported significant improvement in several PROs at minimum 5-year follow-up. Moreover, outcomes were comparable with those of a propensity-matched control group without acetabular overcoverage. Furthermore, the rate of achieving the MCID for the mHHS, HOS-SSS, and NAHS was similar between these groups.
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Affiliation(s)
| | | | - Jacob Shapira
- American Hip Institute Research Foundation, Chicago, Illinois, USA
| | | | - Cynthia Kyin
- American Hip Institute Research Foundation, Chicago, Illinois, USA
| | - Hari K Ankem
- American Hip Institute Research Foundation, Chicago, Illinois, USA
| | - Ajay C Lall
- American Hip Institute Research Foundation, Chicago, Illinois, USA.,American Hip Institute, Chicago, Illinois, USA.,AMITA Health St. Alexius Medical Center, Hoffman Estates, Illinois, USA
| | - Benjamin G Domb
- American Hip Institute Research Foundation, Chicago, Illinois, USA.,American Hip Institute, Chicago, Illinois, USA.,AMITA Health St. Alexius Medical Center, Hoffman Estates, Illinois, USA
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Jackson TJ, Boydstun S. Editorial Commentary: Hip Joint Space as a Predictor of Cartilage Pathology: A Basic Tool for a Complex Task. Arthroscopy 2020; 36:1573-1574. [PMID: 32503771 DOI: 10.1016/j.arthro.2020.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 03/05/2020] [Accepted: 03/06/2020] [Indexed: 02/02/2023]
Abstract
Predicting articular cartilage pathology in the hip with radiographic joint space has been unreliable for patients having joint spaces >2 mm in width. Joint space width is a tool that can be used, but with some limitation. Other methods of investigation such as magnetic resonance imaging should be used in conjunction with radiographic joint space.
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