Purpose
To analyze the effect of acetabular chondrosis at a minimum of 2 years following hip
arthroscopy in patients undergoing labral repair and treatment of femoroacetabular
impingement.
Methods
From 2014 to 2017, patients undergoing arthroscopic labral repair were prospectively
enrolled in a multicenter hip arthroscopy registry. The registry was retrospectively
queried for primary labral repair patients with complete 2-year outcomes and a Tonnis
grade of less than 2. Patients were grouped according to severity of articular cartilage
damage noted intraoperatively using the Beck classification system: none, low-grade
(Grade 1 or 2), or high-grade (Grade 3 or 4) damage. A Kruskal-Wallis test and post
hoc Dunn’s test with Holm correction compared 2-year postoperative outcome scores
of the iHOT-12 scale between groups. The proportion of patients in each cohort who
achieved the clinically significant thresholds of the minimum clinically important
difference (MCID), patient-acceptable symptom scale, and substantial clinical benefit
(SCB) were analyzed. Multivariate logistic regression models identified predictors
of achieving clinical thresholds while controlling for demographic variation.
Results
422 patients met inclusion criteria, from which 347 completed 2-year outcomes. All
groups experienced improvement in iHOT-12 scores from baseline to follow-up (P < .001). iHOT-12 scores at follow-up were inferior for Low-Grade Damage and High-Grade
Damage Groups relative to the No Damage Group (P = .04; P = .03). When accounting for age, body mass index, gender, and preoperative iHOT-12
scores in logistic regression models, the presence of high-grade lesions was a negative
predictor for achieving SCB (OR [95% CI], 0.54 [0.29-0.96]) and low-grade lesions
a negative predictor for achieving MCID (0.50 [0.27-0.92]. Among patients with high-grade
lesions, there was no significant difference in 2-year iHOT-12 scores between those
undergoing chondroplasty (n = 50) and those undergoing microfracture (n = 14) (P = .14).
Conclusions
Acetabular cartilage damage portends inferior patient-reported outcomes 2 years after
primary labral repair and treatment of femoroacetabular impingement. The presence
of cartilage lesions was a negative predictor of individual achievement of several
clinical thresholds.
Level of Evidence
III, Retrospective comparative cohort
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Article Info
Publication History
Published online: June 15, 2022
Accepted:
May 24,
2022
Received in revised form:
May 24,
2022
Received:
December 21,
2021
Publication stage
In Press Journal Pre-ProofFootnotes
The authors report the following potential conflicts of interest or sources of funding: D.S.C. reports consulting fees from Biomet, Linvatec, and DePuy Orthopaedics and speaking fees for Arthrex, Smith & Nephew, and Wright Medical Technology. T.E.U. reports consulting fees from Arthrex and Stryker Corporation. J.J.C. reports grants from Allegheny Singer Research Institute; consulting fees from Arthrex and Stryker Corporation; and speaker fees from Mid-Atlantic Surgical Systems LLC. J.P.S. reports consulting fees from Stryker Corporation; speaker fees from Liberty Surgical, Inc. D.K.M. reports speaker fees for Pacira Pharmaceuticals. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
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© 2022 by the Arthroscopy Association of North America
