Nils Wirries1, Marco Ezechieli2, Michael Schwarze3, Alexander Derksen4, Stefan Budde4, Manuel Ribas5, Henning Windhagen4, Thilo Floerkemeier6. 1. Department of Orthopaedic Surgery At Diakovere Annastift (Hannover Medical School), Anna-von-Borries-Str. 1-7, 30625, Hannover, Germany. nils.wirries@diakovere.de. 2. Department of Orthopaedic Surgery, St. Josefs-Krankenhaus Salzkotten, Salzkotten, Germany. 3. Laboratory for Biomechanics and Biomaterials, Hannover Medical School, Hannover, Germany. 4. Department of Orthopaedic Surgery At Diakovere Annastift (Hannover Medical School), Anna-von-Borries-Str. 1-7, 30625, Hannover, Germany. 5. Instituto Catalán de Traumatología Y Medicina Deportiva (ICATME), Hospital Universitario Quirón Dexeus, Barcelona, Spain. 6. go:h Gelenkchirurgie Orthopädie: Hannover, Hannover, Germany.
Abstract
PURPOSE: The purpose of this study was to analyze predicting factors for a conversion to a total hip replacement (THR) after mini-open arthrotomy for treatment of femoroacetabular impingement (FAI). METHODS: Between 2011 and 2016, we identified 32 patients, who were treated for FAI with a mini-open arthrotomy and received after mean time of 2.1 ± 1.4 years a THR. These patients were compared to 47 cases who did not receive a THR (mean follow-up: 4.3 ± 0.7 years) to explore pre- and intra-operative factors associated with a conversion to THR. The results were presented in separated Kaplan-Meier curves with log rank test for significance and hazard ratios. RESULTS: A lateral joint space width of > 4 mm showed a higher THR-free survival rate compared to < 4 mm (p = 0.001); analogously one-sided (acetabular/femoral) 3-4° cartilage damage had a comparable THR-free survival rate than 1-2° kissing lesions (p = 0.001). Furthermore, an intact labrum without treatment and good cartilage status, a refixed labrum after rim resection in case of a pincer type FAI, or a refixed teared labrum were associated with a longer THR-free time than an untreated labrum accompanied by a poor cartilage status or an ossified labrum (p = 0.002). The strongest independent factor for a conversion to THR was femoral cartilage damage grade 1 and higher (p = 0.046). However, the rate of available patients was 53.0%. CONCLUSION: The success of a joint-preserving mini-open arthrotomy seems to be dependent on the status of the radiological joint space width and the intra-operative cartilage status of the lateral edge.
PURPOSE: The purpose of this study was to analyze predicting factors for a conversion to a total hip replacement (THR) after mini-open arthrotomy for treatment of femoroacetabular impingement (FAI). METHODS: Between 2011 and 2016, we identified 32 patients, who were treated for FAI with a mini-open arthrotomy and received after mean time of 2.1 ± 1.4 years a THR. These patients were compared to 47 cases who did not receive a THR (mean follow-up: 4.3 ± 0.7 years) to explore pre- and intra-operative factors associated with a conversion to THR. The results were presented in separated Kaplan-Meier curves with log rank test for significance and hazard ratios. RESULTS: A lateral joint space width of > 4 mm showed a higher THR-free survival rate compared to < 4 mm (p = 0.001); analogously one-sided (acetabular/femoral) 3-4° cartilage damage had a comparable THR-free survival rate than 1-2° kissing lesions (p = 0.001). Furthermore, an intact labrum without treatment and good cartilage status, a refixed labrum after rim resection in case of a pincer type FAI, or a refixed teared labrum were associated with a longer THR-free time than an untreated labrum accompanied by a poor cartilage status or an ossified labrum (p = 0.002). The strongest independent factor for a conversion to THR was femoral cartilage damage grade 1 and higher (p = 0.046). However, the rate of available patients was 53.0%. CONCLUSION: The success of a joint-preserving mini-open arthrotomy seems to be dependent on the status of the radiological joint space width and the intra-operative cartilage status of the lateral edge.
Authors: Marco Ezechieli; Federico De Meo; Vittorio Bellotti; Carlomagno Cardenas; Emmanuele Astarita; Pietro Cavaliere; Henning Windhagen; Manuel Ribas Journal: Technol Health Care Date: 2016-05-18 Impact factor: 1.285
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