Acetabular Morphologic Characteristics Predict Early Conversion to Arthroplasty After Isolated Hip Arthroscopy for Femoroacetabular Impingement

被引:25
作者
Giordano, Brian D. [1 ,2 ]
Kuhns, Benjamin D. [1 ,2 ]
Perets, Itay [1 ,3 ]
Yuen, Leslie [1 ,3 ]
Domb, Benjamin G. [1 ,3 ]
机构
[1] Amer Hip Inst, Westmont, IL USA
[2] Univ Rochester, Med Ctr, Dept Orthopaed & Rehabil, 601 Elmwood Ave,Box 665, Rochester, NY 14607 USA
[3] Amer Hip Inst, USA Hinsdale Orthoped, Westmont, IL USA
关键词
hip arthroscopy; femoroacetabular impingement; hip; imaging; CLINICAL-OUTCOMES; LABRAL PRESERVATION; CAPSULAR PLICATION; DYSPLASIA; INSTABILITY; CARTILAGE; OSTEOARTHRITIS; DISLOCATION; MANAGEMENT; FAILURE;
D O I
10.1177/0363546519888894
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Background: Hip arthroscopy in the setting of dysplasia and borderline dysplasia is controversial. Dysplasia severity is most often defined by the lateral center edge angle (LCEA) but can also be evaluated radiographically by the acetabular inclination (AI). Purpose/Hypothesis: The purpose was to determine the effect of AI on outcomes after isolated hip arthroscopy for femoroacetabular impingement (FAI). We hypothesized that patients with dysplasia would have higher rates of arthroplasty as well as inferior clinical and functional outcomes compared with patients who did not have dysplasia. Study Design: Cohort study; Level of evidence, 3. Methods: A hip arthroscopy registry was reviewed for participants undergoing arthroscopic correction of FAI from February 28, 2008, to June 10, 2013. Participants required a clinical diagnosis and isolated arthroscopic correction of FAI with preoperative imaging and intraoperative cartilage status recorded. AI dysplasia was defined as an AI greater than 10 degrees, LCEA dysplasia as LCEA less than 18 degrees, and borderline LCEA dysplasia as LCEA 18 degrees to 25 degrees. Patients without an acetabular deformity (LCEA 25 degrees-40 degrees; AI <10 degrees) served as a control population. Postoperative variables included patient-reported outcome surveys with conversion to arthroplasty as the primary endpoint. Minimum 5-year outcome scores were obtained for 337 of 419 patients (80.4%) with an average follow-up of 75.2 +/- 12.7 months. Results: This study included 419 patients: 9 (2%) with LCEA dysplasia, 42 (10%) with AI dysplasia, and 51 (12%) with borderline dysplasia. The AI but not LCEA was significantly correlated with lower outcome scores on the modified Harris Hip Score (r = 0.13; P = .01), Non-Arthritic Hip Score (r = 0.10; P = .04), and Hip Outcome Score-Sports Subscale (r = 0.11; P = .04). A total of 58 patients (14%) underwent arthroplasty at 31 +/- 20 months postoperatively. Patients with LCEA dysplasia had an arthroplasty rate of 56% (odds ratio, 8.4), whereas patients with AI dysplasia had an arthroplasty rate of 31% (odds ratio, 3.3), which was significantly greater than the rate for the nondysplastic cohort (13.5%; P < .0001). Patients with borderline LCEA dysplasia did not have increased rates of arthroplasty. A multivariate analysis found increasing age, increasing AI, Tonnis grade higher than 1, and femoral Outerbridge grade higher than 2 to be most predictive of conversion to arthroplasty. Conclusion: We found that an elevated AI, along with increasing age, Tonnis grade, and femoral Outerbridge grade significantly predict early conversion to arthroplasty after isolated hip arthroscopy. We recommend using the AI, in addition to the LCEA, in evaluating hip dysplasia before hip arthroscopy.
引用
收藏
页码:188 / 196
页数:9
相关论文
共 49 条
  • [11] Cartilage Status at Time of Arthroscopy Predicts Failure in Patients With Hip Dysplasia
    Dwyer, Maureen K.
    Lee, Jo-Ann
    McCarthy, Joseph C.
    [J]. JOURNAL OF ARTHROPLASTY, 2015, 30 (09) : 121 - 124
  • [12] The Effect of Femoral and Acetabular Version on Clinical Outcomes After Arthroscopic Femoroacetabular Impingement Surgery
    Fabricant, Peter D.
    Fields, Kara G.
    Taylor, Samuel A.
    Magennis, Erin
    Bedi, Asheesh
    Kelly, Bryan T.
    [J]. JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 2015, 97A (07) : 537 - 543
  • [13] Does Primary Hip Arthroscopy Result in Improved Clinical Outcomes?: 2-Year Clinical Follow-up on a Mixed Group of 738 Consecutive Primary Hip Arthroscopies Performed at a High-Volume Referral Center
    Gupta, Asheesh
    Redmond, John M.
    Stake, Christine E.
    Dunne, Kevin F.
    Domb, Benjamin G.
    [J]. AMERICAN JOURNAL OF SPORTS MEDICINE, 2016, 44 (01) : 74 - 82
  • [14] An Increased Iliocapsularis-to-rectus-femoris Ratio Is Suggestive for Instability in Borderline Hips
    Haefeli, Pascal Cyrill
    Steppacher, Simon Damian
    Babst, Doris
    Siebenrock, Klaus Arno
    Tannast, Moritz
    [J]. CLINICAL ORTHOPAEDICS AND RELATED RESEARCH, 2015, 473 (12) : 3725 - 3734
  • [15] Predictors of Poor Clinical Outcome After Arthroscopic Labral Preservation, Capsular Plication, and Cam Osteoplasty in the Setting of Borderline Hip Dysplasia
    Hatakeyama, Akihisa
    Utsunomiya, Hajime
    Nishikino, Shoichi
    Kanezaki, Shiho
    Matsuda, Dean K.
    Sakai, Akinori
    Uchida, Soshi
    [J]. AMERICAN JOURNAL OF SPORTS MEDICINE, 2018, 46 (01) : 135 - 143
  • [16] Trends of hip arthroscopy in the setting of acetabular dysplasia
    Haynes, Jacob A.
    Pascual-Garrido, Cecilia
    An, Tonya W.
    Nepple, Jeffrey J.
    Clohisy, John C.
    [J]. JOURNAL OF HIP PRESERVATION SURGERY, 2018, 5 (03): : 267 - 273
  • [17] Radiographic Comparison of Anterior Acetabular Rim Morphology Between Pincer Femoroacetabular Impingement and Control
    Hellman, Michael D.
    Gross, Christopher E.
    Hart, Michael
    Freeman, Ryan
    Salata, Michael J.
    Bush-Joseph, Charles A.
    Nho, Shane J.
    [J]. ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY, 2016, 32 (03) : 468 - 472
  • [18] The Proximal Hip Joint Capsule and the Zona Orbicularis Contribute to Hip Joint Stability in Distraction
    Ito, Hiroshi
    Song, Yongnam
    Lindsey, Derek P.
    Safran, Marc R.
    Giori, Nicholas J.
    [J]. JOURNAL OF ORTHOPAEDIC RESEARCH, 2009, 27 (08) : 989 - 995
  • [19] Arthroscopic Labral Base Repair in the Hip: Clinical Results of a Described Technique
    Jackson, Timothy J.
    Hanypsiak, Bryan
    Stake, Christine E.
    Lindner, Dror
    El Bitar, Youssef F.
    Domb, Benjamin G.
    [J]. ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY, 2014, 30 (02) : 208 - 213
  • [20] The interface between periacetabular osteotomy, hip arthroscopy and total hip arthroplasty in the young adult hip
    Jakobsen, Stig Storgaard
    Overgaard, Soren
    Soballe, Kjeld
    Ovesen, Ole
    Mygind-Klavsen, Bjarne
    Dippmann, Christian Andreas
    Jensen, Michael Ulrich
    Stuerup, Jens
    Retpen, Jens
    [J]. EFORT OPEN REVIEWS, 2018, 3 (07): : 408 - 417