David R Maldonado1, Joseph R Laseter1, Itay Perets2, Victor Ortiz-Declet3, Austin W Chen4, Ajay C Lall1, Benjamin G Domb5. 1. American Hip Institute, Hinsdale, Illinois, U.S.A. 2. American Hip Institute, Hinsdale, Illinois, U.S.A.; Hadassah Hebrew University Hospital, Jerusalem, Israel. 3. American Hip Institute, Hinsdale, Illinois, U.S.A.; Gotham City Orthopedics, New York, New York, U.S.A. 4. American Hip Institute, Hinsdale, Illinois, U.S.A.; Boulder Centre for Orthopedics, Boulder, Colorado, U.S.A. 5. American Hip Institute, Hinsdale, Illinois, U.S.A.; Hinsdale Orthopaedics, Hinsdale, Illinois, U.S.A.. Electronic address: DrDomb@AmericanHipInstitute.org.
Abstract
PURPOSE: To compare the patient-reported outcomes scores (PROs) of patients with femoroacetabular impingement (FAI), labral tears, and complete ligamentum teres (LT) tears to a matched-pair control group with intact LTs, as well as to report the relative risk of total hip arthroplasty (THA) conversion. METHODS: Data between February 2008 and April 2015 were retrospectively reviewed. Patients undergoing hip arthroscopy included those who had complete LT tear, labral tears, FAI, and minimum 2-year follow-up with modified Harris Hip Score (mHHS), Non-arthritic Hip Score (NAHS), Hip Outcome Score-Sports Specific Subscale (HOS-SSS), International Hip Outcome Tool-12 (iHOT-12), and visual analog scale (VAS). Patients were excluded for Tönnis osteoarthritis grade >1, previous hip conditions or surgeries, and Worker's Compensation claims. Patients with full LT tears were matched in a 1:3 ratio with patients without LT tears based on age at surgery ± 5 years, sex, body mass index ± 5, capsular treatment, and acetabular Outerbridge grade. Revision surgeries and conversions to THA were documented. Relative risk for conversion to THA was determined (P = .05). RESULTS: Eighteen patients (18 hips) had minimum 2-year follow-up and were eligible for matching; as described, each study group patient was matched to 3 control patients, resulting in a size of 18 to 54 patients. PROs showed significant improvement in the complete LT tear group with the exception of the HOS-SSS measure. In the intact LT control group, all PROs significantly improved, with no exception. Based on relative risk, patients with complete LT tears were 3 times more likely to require THA than a matched control group. CONCLUSIONS: After hip arthroscopy, patients with FAI and complete LT tears reported significant improvement in PROs. Among hips that did not require THA, functional scores were comparable to a matched control group. However, patients with complete LT tears were 3 times more likely to require an eventual THA than the matched control group. We conclude that patients with complete LT tears should be considered an at-risk population, and that indications and treatment may be refined to incorporate the clinical significance of complete LT tears. LEVEL OF EVIDENCE: Level III, comparative trial, case-control.
PURPOSE: To compare the patient-reported outcomes scores (PROs) of patients with femoroacetabular impingement (FAI), labral tears, and complete ligamentum teres (LT) tears to a matched-pair control group with intact LTs, as well as to report the relative risk of total hip arthroplasty (THA) conversion. METHODS: Data between February 2008 and April 2015 were retrospectively reviewed. Patients undergoing hip arthroscopy included those who had complete LT tear, labral tears, FAI, and minimum 2-year follow-up with modified Harris Hip Score (mHHS), Non-arthritic Hip Score (NAHS), Hip Outcome Score-Sports Specific Subscale (HOS-SSS), International Hip Outcome Tool-12 (iHOT-12), and visual analog scale (VAS). Patients were excluded for Tönnis osteoarthritis grade >1, previous hip conditions or surgeries, and Worker's Compensation claims. Patients with full LT tears were matched in a 1:3 ratio with patients without LT tears based on age at surgery ± 5 years, sex, body mass index ± 5, capsular treatment, and acetabular Outerbridge grade. Revision surgeries and conversions to THA were documented. Relative risk for conversion to THA was determined (P = .05). RESULTS: Eighteen patients (18 hips) had minimum 2-year follow-up and were eligible for matching; as described, each study group patient was matched to 3 control patients, resulting in a size of 18 to 54 patients. PROs showed significant improvement in the complete LT tear group with the exception of the HOS-SSS measure. In the intact LT control group, all PROs significantly improved, with no exception. Based on relative risk, patients with complete LT tears were 3 times more likely to require THA than a matched control group. CONCLUSIONS: After hip arthroscopy, patients with FAI and complete LT tears reported significant improvement in PROs. Among hips that did not require THA, functional scores were comparable to a matched control group. However, patients with complete LT tears were 3 times more likely to require an eventual THA than the matched control group. We conclude that patients with complete LT tears should be considered an at-risk population, and that indications and treatment may be refined to incorporate the clinical significance of complete LT tears. LEVEL OF EVIDENCE: Level III, comparative trial, case-control.
Authors: David R Maldonado; Mitchell J Yelton; Philip J Rosinsky; Jacob Shapira; Mitchell B Meghpara; Ajay C Lall; Benjamin G Domb Journal: BMC Musculoskelet Disord Date: 2020-06-23 Impact factor: 2.362
Authors: David R Maldonado; Jeffrey W Chen; Ajay C Lall; Cammille C Go; Rafael Walker-Santiago; Philip J Rosinsky; Jacob Shapira; Benjamin G Domb Journal: Arthrosc Tech Date: 2019-09-19
Authors: Blake M Bodendorfer; Thomas D Alter; Steven F DeFroda; Andrew B Wolff; Dominic S Carreira; John J Cristoforetti; Dean K Matsuda; John P Salvo; Benjamin R Kivlan; Shane J Nho Journal: Orthop J Sports Med Date: 2021-09-27
Authors: Ajay C Lall; Hari K Ankem; Michael K Ryan; David P Beason; Samantha C Diulus; Ryan P Roach; Philip J Rosinsky; David R Maldonado; Benton A Emblom; Benjamin G Domb Journal: Orthop J Sports Med Date: 2021-12-02
Authors: David R Maldonado; Cammille C Go; Joseph R Laseter; Ajay C Lall; Michael R Kopscik; Benjamin G Domb Journal: J Hip Preserv Surg Date: 2019-07-23