Dean K Matsuda1, Benjamin R Kivlan2, Shane J Nho3, Andrew B Wolff4, John P Salvo5, John J Christoforetti6, Thomas J Ellis7, Dominic S Carreira8. 1. DISC Sports and Spine Center, Marina del Rey, California, U.S.A.. Electronic address: saltandlight777@hotmail.com. 2. Department of Physical Therapy, Rangos School of Health Sciences, Duquesne University, Pittsburgh, Pennsylvania, U.S.A. 3. Department of Orthopedic Surgery, Division of Sports Medicine, Hip Preservation Center, Rush University Medical Center, Chicago, Illinois, U.S.A. 4. Hip Preservation and Sports Medicine, Washington Orthopaedics and Sports Medicine, Washington, DC, U.S.A. 5. Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, U.S.A. 6. Texas Health Resources, Allen, Texas, U.S.A. 7. Orthopedics ONE, Dublin, Ohio, U.S.A. 8. Peachtree Orthopedics, Atlanta, Georgia, U.S.A.
Abstract
PURPOSE: To report comparative hip arthroscopic outcomes of patients with low (borderline dysplasia), normal, and high (global pincer femoroacetabular impingement [FAI]) lateral acetabular coverage. METHODS: A retrospective analysis of prospectively collected data from a multicenter registry was performed. Primary hip arthroscopy patients were assigned to 1 of 3 groups based on preoperative lateral center-edge angle: borderline dysplasia (≤25°), normal (25.1°-38.9°), and pincer (≥39°). Repeated-measures analysis of variance compared preoperative with 2-year minimum postoperative International Hip Outcome Tool (iHOT-12) scores. Subsequent analysis of variance determined the effect of acetabular coverage on magnitude of change in scores. RESULTS: Of 437 patients, the only statistical difference between groups was a lower prevalence of acetabuloplasty in the borderline dysplasia group (P = .001). A significant improvement in the preoperative to postoperative iHOT-12 scores for patients with normal acetabular coverage, acetabular undercoverage, and acetabular overcoverage was observed: F(1, 339) = 311.06; P <.001, with no statistical differences in preoperative (P = .505) and postoperative (P <.488) iHOT-12 scores when comparing the groups based on acetabular coverage. Mean iHOT-12 scores increased from 37.3 preoperatively to 68.7 postoperatively (P <.001) in the borderline dysplasia group, from 34.4 to 72 (P <.001) in the normal coverage group, and from 35.3 to 69.4 (P <.001) in the pincer group. These preoperative scores increased by 31.4, 37.8, and 34.1, respectively, with no effect for acetabular coverage on the magnitude of change from preoperative to postoperative iHOT-12 scores: F(2,339) = 1.18; P = .310. Ten patients (2.3%) underwent conversion arthroplasty, and 19 patients (4.4%) underwent revision arthroscopy with no significant effect of acetabular coverage on the incidence of revision or conversion surgery: χ2 (6,433) = 11.535; P = .073. CONCLUSIONS: Lateral acetabular coverage did not influence outcomes from primary hip arthroscopy when performed in patients with low (borderline dysplasia), normal, and high (global pincer FAI) lateral center-edge angle. Borderline dysplasia and moderate global pincer FAI with no or minimal osteoarthritis do not compromise successful 2-year minimum outcomes or survivorship following primary hip arthroscopy when performed by experienced surgeons. LEVEL OF EVIDENCE: Level III, retrospective therapeutic trial.
PURPOSE: To report comparative hip arthroscopic outcomes of patients with low (borderline dysplasia), normal, and high (global pincer femoroacetabular impingement [FAI]) lateral acetabular coverage. METHODS: A retrospective analysis of prospectively collected data from a multicenter registry was performed. Primary hip arthroscopypatients were assigned to 1 of 3 groups based on preoperative lateral center-edge angle: borderline dysplasia (≤25°), normal (25.1°-38.9°), and pincer (≥39°). Repeated-measures analysis of variance compared preoperative with 2-year minimum postoperative International Hip Outcome Tool (iHOT-12) scores. Subsequent analysis of variance determined the effect of acetabular coverage on magnitude of change in scores. RESULTS: Of 437 patients, the only statistical difference between groups was a lower prevalence of acetabuloplasty in the borderline dysplasia group (P = .001). A significant improvement in the preoperative to postoperative iHOT-12 scores for patients with normal acetabular coverage, acetabular undercoverage, and acetabular overcoverage was observed: F(1, 339) = 311.06; P <.001, with no statistical differences in preoperative (P = .505) and postoperative (P <.488) iHOT-12 scores when comparing the groups based on acetabular coverage. Mean iHOT-12 scores increased from 37.3 preoperatively to 68.7 postoperatively (P <.001) in the borderline dysplasia group, from 34.4 to 72 (P <.001) in the normal coverage group, and from 35.3 to 69.4 (P <.001) in the pincer group. These preoperative scores increased by 31.4, 37.8, and 34.1, respectively, with no effect for acetabular coverage on the magnitude of change from preoperative to postoperative iHOT-12 scores: F(2,339) = 1.18; P = .310. Ten patients (2.3%) underwent conversion arthroplasty, and 19 patients (4.4%) underwent revision arthroscopy with no significant effect of acetabular coverage on the incidence of revision or conversion surgery: χ2 (6,433) = 11.535; P = .073. CONCLUSIONS: Lateral acetabular coverage did not influence outcomes from primary hip arthroscopy when performed in patients with low (borderline dysplasia), normal, and high (global pincer FAI) lateral center-edge angle. Borderline dysplasia and moderate global pincer FAI with no or minimal osteoarthritis do not compromise successful 2-year minimum outcomes or survivorship following primary hip arthroscopy when performed by experienced surgeons. LEVEL OF EVIDENCE: Level III, retrospective therapeutic trial.
Authors: Ida Lindman; Sarantos Nikou; Axel Öhlin; Eric Hamrin Senorski; Olufemi Ayeni; Jon Karlsson; Mikael Sansone Journal: J Exp Orthop Date: 2021-04-23
Authors: Enrico Tassinari; Federica Mariotti; Francesco Castagnini; Stefano Lucchini; Francesco Perdisa; Giovanni Bracci; Monica Cosentino; Barbara Bordini; Francesco Traina Journal: J Exp Orthop Date: 2021-12-03