Purpose
To define the clinical effect of intra-articular injection of iliac crest–derived
bone marrow aspirate concentrate (BMAC) at the time of hip arthroscopy in patients
with symptomatic labral tears and early radiographic degenerative changes.
Methods
A retrospective review of a prospectively collected hip registry database was performed.
Patients with symptomatic labral tears and Tönnis grade 1 or 2 degenerative changes
who underwent labrum-preserving hip arthroscopy with BMAC injection were included
and were matched with patients who underwent hip arthroscopy without BMAC injection.
Patient-reported outcomes (PROs) collected preoperatively and up to 2 years postoperatively
included the modified Harris Hip Score, Hip Outcome Score–Activities of Daily Living,
Hip Outcome Score–Sport, and International Hip Outcome Tool 33 score. Clinical relevance
was measured with the minimal clinically important difference, patient acceptable
symptom state, and substantial clinical benefit for each outcome score.
Results
A total of 35 patients underwent labrum-preserving hip arthroscopy with BMAC injection
and were matched with 35 control patients. There were no differences in demographic
characteristics between the groups (P > .05). The BMAC group consisted of 22 patients (62.9%) with Tönnis grade 1 changes
and 13 (37.1%) with Tönnis grade 2 changes, whereas all 35 control patients had Tönnis
grade 0 hips. All PROs were significantly improved in both groups at 2 years, with
no difference in improvement. The rate of failure requiring conversion to total hip
arthroplasty was 14.3% (mean, 1.6 years postoperatively) in the BMAC group and 5.7%
(mean, 7 years postoperatively) in the control group (P = .09). The difference in the frequency of patients achieving the minimal clinically
important difference, patient acceptable symptom state, and substantial clinical benefit
was not statistically significant between cohorts.
Conclusions
In a challenging group of patients with symptomatic labral tears and early radiographic
degenerative changes, hip arthroscopy with BMAC injection results in statistically
and clinically significant improvement in PROs comparable to a group of patients with
nonarthritic hips undergoing hip arthroscopy at short-term follow-up.
Level of Evidence
Level III, retrospective comparative therapeutic trial.
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Article info
Publication history
Published online: December 24, 2022
Accepted:
December 1,
2022
Received:
October 4,
2021
Publication stage
In Press Journal Pre-ProofFootnotes
The authors report the following potential conflicts of interest or sources of funding: A.S.R. is a paid consultant for Arthrex, Ceramtec, Medtronic, Moximed, Pfizer, and Smith & Nephew; owns stock or stock options in ConforMIS and Enhatch; receives research support from DePuy Mitek-Synthes and Stryker; and receives intellectual property royalties from DePuy (A Johnson & Johnson Company) and Stryker Mako, outside the submitted work. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
The study data were presented as oral presentations at the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) 2021 Global Congress (paper No. 20481) in November 27-28, 2021 and the International Society for Hip Arthroscopy (ISHA) October 2020 meeting.
Identification
Copyright
© 2023 by the Arthroscopy Association of North America
