Karen K Briggs1, Eduardo Soares2, Sanjeev Bhatia3, Marc J Philippon2. 1. Steadman Philippon Research Institute, 181 W. Meadow Dr. Ste 1000, Vail, CO, 81637, USA. Karen.briggs@sprivail.org. 2. Steadman Philippon Research Institute, 181 W. Meadow Dr. Ste 1000, Vail, CO, 81637, USA. 3. Cincinnati Sports Medicine Center, Cincinnati, OH, USA.
Abstract
PURPOSE: The most commonly used parameter for defining cam-type femoroacetabular impingement(FAI) has been the alpha angle. The purpose of this study was to determine if patient-reported outcomes 5 years following hip arthroscopy for FAI were associated with postoperative alpha angle. We hypothesized that patient-reported outcomes would not be influenced by postoperative alpha angle in patients with FAI. METHODS: 230 patients had primary hip arthroscopy for FAI and chondrolabral dysfunction. The median age was 40 years (range 18-69). All patients had preoperative and 1 day postoperative alpha angles recorded. At minimum 5 years following arthroscopy, all patients completed an online questionnaire that included the modified Harris Hip score(MHHS), WOMAC, HOS ADL, HOS Sport, SF12 and patient satisfaction. This study was IRB approved. Patients were grouped into two, based on their postoperative alpha angle: <55° (n = 158) and ≥ 55° (n = 56). RESULTS: The median preoperative alpha angle was 72° (range 50°-105°) and the median postoperative alpha angle was 45° (range 30°-100°). The postoperative alpha angle did not correlate with any outcome measure. The median preoperative alpha angle in the < 55° group was 71° and in ≥ 55° group the median was 74° (p = 0.044). The median follow-up was 5.1 years (range 5-7). The median mHHS was 85 (range 47-100) in the < 55° and 85 (range 54-100) in the ≥ 55° group (n.s); WOMAC was 5 (range 0-73) in the < 55° and 4.5 (range 1-57) in the ≥ 55° group(n.s); HOS ADL was 95 (range 31-100) in the < 55° and 96 (range 50-100) in the ≥ 55° group (n.s); HOS Sport was 88 (range 0-100) in the < 55° and 88 (range 13-100) in the ≥ 55° group (n.s) Median patient satisfaction was 9 (range 1-10) in both groups. CONCLUSION: This study shows no statistically significant differences between the investigated patient-reported outcome scores at a 5 years postoperatively in relation to a correction of the alpha angle to 55°. While alpha angle has been shown to be an excellent preoperative diagnostic tool, the postoperative angle does not correlate with midterm outcomes or the development of osteoarthritis based on patient symptoms. The amount of osteoplasty should be based on dynamic examination at arthroscopy, and not by alpha angle. LEVEL OF EVIDENCE: III Case-control, retrospective comparative study.
PURPOSE: The most commonly used parameter for defining cam-type femoroacetabular impingement(FAI) has been the alpha angle. The purpose of this study was to determine if patient-reported outcomes 5 years following hip arthroscopy for FAI were associated with postoperative alpha angle. We hypothesized that patient-reported outcomes would not be influenced by postoperative alpha angle in patients with FAI. METHODS: 230 patients had primary hip arthroscopy for FAI and chondrolabral dysfunction. The median age was 40 years (range 18-69). All patients had preoperative and 1 day postoperative alpha angles recorded. At minimum 5 years following arthroscopy, all patients completed an online questionnaire that included the modified Harris Hip score(MHHS), WOMAC, HOS ADL, HOS Sport, SF12 and patient satisfaction. This study was IRB approved. Patients were grouped into two, based on their postoperative alpha angle: <55° (n = 158) and ≥ 55° (n = 56). RESULTS: The median preoperative alpha angle was 72° (range 50°-105°) and the median postoperative alpha angle was 45° (range 30°-100°). The postoperative alpha angle did not correlate with any outcome measure. The median preoperative alpha angle in the < 55° group was 71° and in ≥ 55° group the median was 74° (p = 0.044). The median follow-up was 5.1 years (range 5-7). The median mHHS was 85 (range 47-100) in the < 55° and 85 (range 54-100) in the ≥ 55° group (n.s); WOMAC was 5 (range 0-73) in the < 55° and 4.5 (range 1-57) in the ≥ 55° group(n.s); HOS ADL was 95 (range 31-100) in the < 55° and 96 (range 50-100) in the ≥ 55° group (n.s); HOS Sport was 88 (range 0-100) in the < 55° and 88 (range 13-100) in the ≥ 55° group (n.s) Median patient satisfaction was 9 (range 1-10) in both groups. CONCLUSION: This study shows no statistically significant differences between the investigated patient-reported outcome scores at a 5 years postoperatively in relation to a correction of the alpha angle to 55°. While alpha angle has been shown to be an excellent preoperative diagnostic tool, the postoperative angle does not correlate with midterm outcomes or the development of osteoarthritis based on patient symptoms. The amount of osteoplasty should be based on dynamic examination at arthroscopy, and not by alpha angle. LEVEL OF EVIDENCE: III Case-control, retrospective comparative study.
Entities:
Keywords:
Alpha angle; Diagnosis; Femoroacetabular impingement; Hip arthroscopy; Outcomes
Authors: José M Lamo-Espinosa; Adrián Alfonso; Elena Pascual; Jorge García-Ausín; Miguel Sánchez-Gordoa; Asier Blanco; Jorge Gómez-Álvarez; Mikel San-Julián Journal: Diagnostics (Basel) Date: 2022-05-02
Authors: Melisa L Wong; Steven M Paul; Judy Mastick; Christine Ritchie; Michael A Steinman; Louise C Walter; Christine Miaskowski Journal: J Pain Symptom Manage Date: 2018-08-23 Impact factor: 3.612
Authors: Kevin H Nguyen; Chace Shaw; Thomas M Link; Sharmila Majumdar; Richard B Souza; Thomas P Vail; Alan L Zhang Journal: Arthroscopy Date: 2021-05-28 Impact factor: 4.772
Authors: Dan Cohen; Abdullah Khan; Jeffrey Kay; David Slawaska-Eng; Mahmoud Almasri; Nicole Simunovic; Andrew Duong; Marc R Safran; Olufemi R Ayeni Journal: Knee Surg Sports Traumatol Arthrosc Date: 2021-06-26 Impact factor: 4.114
Authors: David R Maldonado; Sarah L Chen; Jeffery W Chen; Jacob Shapira; Philip J Rosinksy; Shawn Annin; Ajay C Lall; Benjamin G Domb Journal: Orthop J Sports Med Date: 2020-07-27
Authors: Tyler R Youngman; K John Wagner; Benjamin Montanez; Benjamin L Johnson; Phillip L Wilson; William Z Morris; Daniel J Sucato; David A Podeszwa; Henry B Ellis Journal: J Pediatr Orthop Date: 2021-02-01 Impact factor: 2.537