Ashley L Kapron1,2, Stephen K Aoki1, Jeffrey A Weiss1,3, Aaron J Krych4, Travis G Maak5. 1. Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT, 84108, USA. 2. Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA. 3. Department of Bioengineering, University of Utah, Salt Lake City, UT, USA. 4. Department of Orthopedic Surgery and Sports Medicine, Mayo Clinic, Rochester, MN, USA. 5. Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT, 84108, USA. Travis.Maak@hsc.utah.edu.
Abstract
PURPOSE: Develop a framework to quantify the size, location and severity of femoral and acetabular-sided cartilage and labral damage observed in patients undergoing hip arthroscopy, and generate a database of individual defect parameters to facilitate future research and treatment efforts. METHODS: The size, location, and severity of cartilage and labral damage were prospectively collected using a custom, standardized post-operative template for 100 consecutive patients with femoroacetabular impingement syndrome. Chondrolabral junction damage, isolated intrasubstance labral damage, isolated acetabular cartilage damage and femoral cartilage damage were quantified and recorded using a combination of Beck and ICRS criteria. Radiographic measurements including alpha angle, head-neck offset, lateral centre edge angle and acetabular index were calculated and compared to the aforementioned chondral data using a multivariable logistic regression model and adjusted odd's ratio. Reliability among measurements were assessed using the kappa statistic and intraclass coefficients were used to evaluate continuous variables. RESULTS: Damage to the acetabular cartilage originating at the chondrolabral junction was the most common finding in 97 hips (97%) and was usually accompanied by labral damage in 65 hips (65%). The width (p = 0.003) and clock-face length (p = 0.016) of the damaged region both increased alpha angle on anteroposterior films. 10% of hips had femoral cartilage damage while only 2 (2%) of hips had isolated defects to either the acetabular cartilage or labrum. The adjusted odds of severe cartilage (p = 0.022) and labral damage (p = 0.046) increased with radiographic cam deformity but was not related to radiographic measures of acetabular coverage. CONCLUSIONS: Damage at the chondrolabral junction was very common in this hip arthroscopy cohort, while isolated defects to the acetabular cartilage or labrum were rare. These data demonstrate that the severity of cam morphology, quantified through radiographic measurements, is a primary predictor of location and severity of chondral and labral damage and focal chondral defects may represent a unique subset of patients that deserve further study. LEVEL OF EVIDENCE: IV.
PURPOSE: Develop a framework to quantify the size, location and severity of femoral and acetabular-sided cartilage and labral damage observed in patients undergoing hip arthroscopy, and generate a database of individual defect parameters to facilitate future research and treatment efforts. METHODS: The size, location, and severity of cartilage and labral damage were prospectively collected using a custom, standardized post-operative template for 100 consecutive patients with femoroacetabular impingement syndrome. Chondrolabral junction damage, isolated intrasubstance labral damage, isolated acetabular cartilage damage and femoral cartilage damage were quantified and recorded using a combination of Beck and ICRS criteria. Radiographic measurements including alpha angle, head-neck offset, lateral centre edge angle and acetabular index were calculated and compared to the aforementioned chondral data using a multivariable logistic regression model and adjusted odd's ratio. Reliability among measurements were assessed using the kappa statistic and intraclass coefficients were used to evaluate continuous variables. RESULTS: Damage to the acetabular cartilage originating at the chondrolabral junction was the most common finding in 97 hips (97%) and was usually accompanied by labral damage in 65 hips (65%). The width (p = 0.003) and clock-face length (p = 0.016) of the damaged region both increased alpha angle on anteroposterior films. 10% of hips had femoral cartilage damage while only 2 (2%) of hips had isolated defects to either the acetabular cartilage or labrum. The adjusted odds of severe cartilage (p = 0.022) and labral damage (p = 0.046) increased with radiographic cam deformity but was not related to radiographic measures of acetabular coverage. CONCLUSIONS: Damage at the chondrolabral junction was very common in this hip arthroscopy cohort, while isolated defects to the acetabular cartilage or labrum were rare. These data demonstrate that the severity of cam morphology, quantified through radiographic measurements, is a primary predictor of location and severity of chondral and labral damage and focal chondral defects may represent a unique subset of patients that deserve further study. LEVEL OF EVIDENCE: IV.
Authors: Rebecca M Woodward; Renuka M Vesey; Catherine J Bacon; Steve G White; Matthew J Brick; Donna G Blankenbaker Journal: Skeletal Radiol Date: 2020-06-25 Impact factor: 2.199
Authors: Jocelyn N Todd; Travis G Maak; Andrew E Anderson; Gerard A Ateshian; Jeffrey A Weiss Journal: Clin Orthop Relat Res Date: 2022-03-01 Impact factor: 4.755
Authors: Joshua Heerey; Joanne Kemp; Rintje Agricola; Ramya Srinivasan; Anne Smith; Tania Pizzari; Matthew King; Peter Lawrenson; Mark Scholes; Thomas Link; Richard Souza; Sharmila Majumdar; Kay Crossley Journal: BMJ Open Sport Exerc Med Date: 2021-12-15