Purpose
To assess whether preoperative joint space measures would be predictive of survivorship
in patients undergoing hip arthroscopy (HA) for femoroacetabular impingement (FAI).
Methods: Data on consecutive patients who underwent hip arthroscopy between February 2008
and February 2018 were retrospectively reviewed. To be eligible for final analysis,
patients were required to have preoperative radiographs for joint space measurements
and data indicating conversion to a total hip arthroplasty (THA), hip resurfacing,
or neither; at a minimum of 2 years after primary hip arthroscopy. Survivorship following
HA was defined as remaining conversion free and served as the primary outcome. A multivariate
logistic regression analysis and receiver operator curve (ROC) were used to evaluate
the correlation between joint space measurements and survivorship following HA. Results: A total of 1,885 primary arthroscopy cases were included in this study. The multivariate
regression analysis found preoperative lateral-to-medial joint space ratio (L/M ratio)
to be the strongest predictive factor of survivorship after primary hip arthroscopy
(OR = 2.084, CI95% = 1.239–3.503; P = .006). The ROC curve for the model demonstrated acceptable discrimination with
an area under the curve (AUC) of 0.792. Patients with an L/M ratio ≥0.75 had a survivorship
rate of 91.7% compared to a rate of 75% for patients with an L/M ratio <0.75 (OR:
3.68). Conclusions: This study found that, of the factors evaluated in this study, the most significant
factor in predicting survivorship at 2 years after undergoing primary hip arthroscopy
was a larger lateral-to-medial joint space ratio. This may suggest an initiation of
primary arthritis at the edge-loading area of the lateral acetabulum.
Level of Evidence
III, retrospective comparative observation study
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References
- Incidence of femoroacetabular impingement and surgical management trends over time.Am J Sports Med. 2021; 49: 35-41
- What is the survivorship after hip arthroscopy for femoroacetabular impingement? A large-database study.Clin Orthop Relat Res. 2020; 478: 2266-2273
- Patient-related risk factors associated with less favourable outcomes following hip arthroscopy: A scoping review.Bone Jt J. 2020; 102-B: 822-831
- Outcome of surgical treatment of hip femoroacetabular impingement patients with radiographic osteoarthritis: A meta-analysis of prospective studies.J Am Acad Orthop Surg. 2019; 27: e70-e76
- Hip arthroplasty after hip arthroscopy: Are short-term outcomes affected? A systematic review of the literature.Arthroscopy. 2019; 35: 2736-2746
- Mid-term patient-reported outcomes of hip arthroplasty after previous hip arthroscopy: A matched case-control study with a minimum 5-year follow-up.J Am Acad Orthop Surg. 2020; 28: 501-510
- Does arthroscopic FAI correction improve function with radiographic arthritis?.Clin Orthop Relat Res. 2011; 469: 1667-1676
- Hip arthroscopy for femoroacetabular impingement in patients aged 50 years or older.Arthroscopy. 2012; 28: 59-65
- Can radiographic joint space accurately predict chondral damage during hip arthroscopy? A cross-sectional analysis.Arthroscopy. 2020; 36: 1565-1572.e1
- Clinical and radiographic predictors of acetabular cartilage lesions in adolescents undergoing hip arthroscopy.Am J Sports Med. 2018; 46: 3082-3089
- Outerbridge grade IV cartilage lesions in the hip identified at arthroscopy.Arthroscopy. 2016; 32: 814-819
- The nonarthritic hip score: Reliable and validated.Clin Orthop Relat Res. 2003; : 75-83
- A systematic approach to the plain radiographic evaluation of the young adult hip.J Bone Joint Surg Am. 2008; 90: 47-66
- Measurement of joint space width in hip osteoarthritis: Influence of joint positioning and radiographic procedure.Rheumatology (Oxford). 2001; 40: 414-419
- No differences in hip joint space measurements between weightbearing or supine anteroposterior pelvic radiographs.Arthroscopy. 2020; 36: 2843-2848
- Reliability of radiographic parameters in adults with hip dysplasia.Skeletal Radiol. 2012; 41: 811-816
- Shelf operation in congenital dysplasia of the acetabulum and in subluxation and dislocation of the hip.J Bone Joint Surg Am. 1953; 35-A: 65-80
- The contour of the femoral head-neck junction as a predictor for the risk of anterior impingement.J Bone Joint Surg Br. 2002; 84: 556-560
- Radiographic and demographic factors can predict the need for primary labral reconstruction in hip arthroscopic surgery: A predictive model using 1398 hips.Am J Sports Med. 2020; 48: 173-180
- What factors predict conversion to THA after arthroscopy?.Clin Orthop Rel Res. 2017; 475: 2538-2545
- Risk factors for ligamentum teres tears.Arthroscopy. 2013; 29: 64-73
- Forget the greater trochanter! Hip joint access with the 12 o’clock portal in hip arthroscopy.Arthrosc Tech. 2019; 8: e575-e584
- Do not take for granted! The art of elevating the capsule in hip arthroscopy: A stepwise approach.Arthrosc Tech. 2019; 8: e883-e887
- Anatomy, histologic features, and vascularity of the adult acetabular labrum.Clin Orthop Rel Res. 2001; 382: 232-240
- The etiology of chondromalacia patellae.J Bone Joint Surg Br. 1961; 43-B: 752-757
- Tears of the ligamentum teres: Prevalence in hip arthroscopy using 2 classification systems.Am J Sports Med. 2011; 39: 117-125
- The ligamentum teres of the hip: an arthroscopic classification of its pathology.Arthroscopy. 1997; 13: 575-578
- Indications and outcomes of secondary hip procedures after failed hip arthroscopy: A systematic review.Arthroscopy. 2020; 36: 1992-2007
- Standardizing the prearthritic hip joint space width: An analysis of 994 hips.Arthroscopy. 2018; 34: 2114-2120
- Joint space narrowing in patients with femoroacetabular impingement: A matched cohort study of military versus civilian patients.Mil Med. 2019; 184: e797-e801
- Lateral acetabular coverage as a predictor of femoroacetabular cartilage thickness.J Hip Preserv Surg. 2016; 3: 262-269
- Acetabular edge loading during gait is elevated by the anatomical deformities of hip dysplasia.Front Sports Act Living. 2021; 3687419
- Three-dimensional distribution of acetabular cartilage thickness in patients with hip dysplasia: A fully automated computational analysis of MR imaging.Osteoarthr Cartil. 2004; 12: 650-657
- Femoral morphology asymmetry in hip dysplasia makes radiological leg length measurement inaccurate.Bone Joint J. 2019; 101-B: 297-302
- The pattern of acetabular cartilage wear is hip morphology-dependent and patient demographic-dependent.Clin Orthop Relat Res. 2019; 477: 1021-1033
- Validation of a risk calculator for conversion of hip arthroscopy to total hip arthroplasty in a consecutive series of 1400 patients.J Arthroplasty. 2019; 34: 1700-1706
- Independent risk factors for revision surgery or conversion to total hip arthroplasty after hip arthroscopy: A review of a large statewide database from 2011 to 2012.Arthroscopy. 2018; 34: 464-470
- Hip arthroscopy in the setting of hip osteoarthritis: Systematic review of outcomes and progression to hip arthroplasty.Clin Orthop Relat Res. 2015; 473: 1055-1073
- Good outcome scores and low conversion rate to THA 10 years after hip arthroscopy for the treatment of femoroacetabular impingement.Clin Orthop Relat Res. 2021; 479: 2256-2264
- Age and outcomes in hip arthroscopy for femoroacetabular impingement: A comparison across 3 age groups.Am J Sports Med. 2021; 49: 82-89
- Obesity is associated with less favorable outcomes following hip arthroscopic surgery: A systematic review and meta-analysis.Knee Surg Sports Traumatol Arthrosc. 2021; 29: 1483-1493
- Hip arthroscopy in patients ages 50 years or older: Minimum 5-year outcomes, survivorship, and risk factors for conversion to total hip replacement.Arthroscopy. 2018; 34: 3001-3009
- Mini-open femoroacetabular osteoplasty: Risk factors for failure and conversion to hip arthroplasty.J Bone Joint Surg Am. 2020; 102: e59
- Use of hip arthroscopy and risk of conversion to total hip arthroplasty: A Population-Based Analysis.Arthroscopy. 2016; 32: 587-593
- Lower center edge angle and bioipolar cartilage lesions are associated with conversion to hip arthroplasty within 2 years following hip arthroscopy: A matched cohort analysis.Arthroscopy. 2022; 38: 1480-1485
- Radiographic predictors of femoroacetabular impingement treatment outcomes.Knee Surg Sports Traumatol Arthrosc. 2017; 25: 36-44
- Arthroscopic outcomes as a function of acetabular coverage from a large hip arthroscopy study group.Arthroscopy. 2019; 35: 2338-2345
- Arthroscopic treatment of femoroacetabular impingement in patients with and without borderline developmental dysplasia of the hip: A systematic review and meta-analysis.Orthop J Sports Med. 2021; 923259671211015972
- No correlation between depth of acetabuloplasty or postoperative lateral center-edge angle on midterm outcomes of hip arthroscopy with acetabuloplasty and labral repair.Am J Sports Med. 2021; 49: 49-54
- What are the risk factors for revision surgery after hip arthroscopy for femoroacetabular impingement at 7-year follow-up?.Clin Orthop Relat Res. 2017; 475: 1169-1177
- Optimal treatment of cam morphology may change the natural history of femoroacetabular impingement.Am J Sports Med. 2020; 48: 2887-2896
Article info
Publication history
Published online: July 06, 2022
Accepted:
June 23,
2022
Received:
August 9,
2021
Footnotes
The authors report the following potential conflicts of interest or sources of funding: P.J.R. reports nonfinancial support from Arthrex, Stryker, Smith & Nephew, and Ossur, outside the submitted work. Dr. Domb reports grants and other from American Orthopedic Foundation, during the conduct of the study; personal fees from Amplitude, grants, personal fees and non-financial support from Arthrex, personal fees and non-financial support from DJO Global, grants, personal fees and non-financial support from Medacta, grants, personal fees, non-financial support and other from Stryker, grants from Breg, personal fees from Orthomerica, grants and nonfinancial support from Medwest Associates, grants from ATI Physical Therapy, personal fees and nonfinancial support from St. Alexius Medical Center, grants from Ossur, outside the submitted work; In addition, Dr. Domb has a patent 8920497 - Method and instrumentation for acetabular labrum reconstruction with royalties paid to Arthrex, a patent 8708941 - Adjustable multicomponent hip orthosis with royalties paid to Orthomerica and DJO Global, and a patent 9737292 - Knotless suture anchors and methods of tissue repair with royalties paid to Arthrex and Dr. Domb is a board member of American Hip Institute Research Foundation, AANA Learning Center Committee, the Journal of Hip Preservation Surgery, the Journal of Arthroscopy; has had ownership interests in the American Hip Institute, Hinsdale Orthopedic Associates, Hinsdale Orthopedic Imaging, SCD#3, North Shore Surgical Suites, and Munster Specialty Surgery Center. 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
