Document Detail


Intraoperative cartilage degeneration predicts outcome 12 months after hip arthroscopy.
MedLine Citation:
PMID:  22992870     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: When considering arthroscopic surgery for treatment of hip pain, it is important to understand the influence of joint degeneration on the likelihood of success. Previous research has shown poorer outcomes among patients with osteoarthritis but new arthroscopic techniques including femoroacetabular impingement correction and microfracture may lead to better arthroscopic outcomes.
QUESTIONS/PURPOSES: We investigated the effect of intraarthroscopic articular and rim cartilage degeneration on the outcome after hip arthroscopy using contemporary techniques.
METHODS: The modified Harris hip score (MHHS) and nonarthritic hip score (NAHS) were completed preoperatively and 12 months postoperatively by 560 patients undergoing hip arthroscopy after March 2007. Change in these scores was compared between patients with and without acetabular or femoral articular cartilage degeneration and between patients with and without rim cartilage degeneration. Correlation and regression analyses were used to predict the change in outcome scores based on the severity of cartilage degeneration.
RESULTS: Hips without degeneration had greater improvement in the outcome scores. The presence of cartilage degeneration showed negative correlations with change in outcomes. The best model to explain change in MHHS included preoperative score, articular cartilage degeneration grade, and rim lesion grade (adjusted R(2) = 0.24).
CONCLUSIONS: Our data support previous findings regarding the negative influence of cartilage degeneration on improvement after hip arthroscopy. Nevertheless, many patients with cartilage degeneration still improved and the severity of degeneration accounts for little of the resulting variance in change. Future studies must determine the clinical importance of the improvements gained by patients with cartilage degeneration and identify other predictors of outcome.
LEVEL OF EVIDENCE: Level III, prognostic study. See Instructions for Authors for a complete description of levels of evidence.
Authors:
Thorlene Egerton; Rana S Hinman; Amir Takla; Kim L Bennell; John O'Donnell
Publication Detail:
Type:  Journal Article     Date:  2012-09-20
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  471     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-01-21     Completed Date:  2013-05-28     Revised Date:  2014-02-04    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  593-9     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Arthroscopy / methods*
Cartilage, Articular / pathology*,  surgery
Female
Hip Joint / pathology,  surgery*
Humans
Male
Middle Aged
Osteoarthritis, Hip / pathology,  surgery*
Predictive Value of Tests
Prognosis
Recovery of Function
Retrospective Studies
Treatment Outcome
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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