Clinical and Radiographic Predictors of Intra-articular Hip Disease in Arthroscopy

Nepple, Jeffrey J.; Carlisle, John C.; Nunley, Ryan M.; Clohisy, John C.

doi:10.1177/0363546510384787

Cited by 132 publications

(140 citation statements)

References 47 publications

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“…Several articles have used Tönnis grade as a descriptive for outcome studies [6,9,13,15,16,22,25]. One recent article excluded patients with Tönnis Grade 2 or greater and greater than 50% narrowing of the joint space and still had 8% conversion to THA [16].…”

Section: Discussionmentioning

confidence: 99%

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Joint Space Predicts THA After Hip Arthroscopy in Patients 50 Years and Older

Philippon

Briggs

Carlisle

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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197

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Background All patients considering joint-preserving hip arthroscopy should be educated on the risk of THA after arthroscopy. The degree of radiographic osteoarthritis predicts subsequent THA. To provide patients with the best information, the best radiographic measure that predicts THA after hip arthroscopy should be identified. Questions/purposes We therefore determined if Tönnis grade, Kellgren-Lawrence grade, or joint space narrowing was superior in predicting THA after hip arthroscopy. Methods We retrospectively reviewed 203 patients 50 years of age or older treated with hip arthroscopy between

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Section: Discussionmentioning

confidence: 99%

“…Several studies [14,15] show a relationship between the Tönnis grade on plain radiographs and the presence of cartilage lesions in the hip at time of surgery. A recent study [13] with a 10-year followup of hip arthroscopy showed the grades of cartilage lesions noted at the time of surgery were predictors of THA.…”

Section: Discussionmentioning

confidence: 99%

Joint Space Predicts THA After Hip Arthroscopy in Patients 50 Years and Older

Philippon

Briggs

Carlisle

et al. 2013

Clinical Orthopaedics &Amp; Related Research

Self Cite

197

152

View full text Add to dashboard Cite

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“…Although it is known that younger patients with no or mild preoperative arthritis have better functional outcome [7], this is the first radiographic predictor of postoperative function to our knowledge. Higher alpha angles have been shown to be associated with cam-type femoroacetabular impingement (FAI) [3,4,13,20]. A recent study by Albers no offset correction in a nonspherical femoral head PAO = periacetabular osteotomy; CEA = center-edge angle; OA = osteoarthritis; LCE = lateral center-edge.…”

Section: Discussionmentioning

confidence: 99%

What Factors Predict Improvements in Outcomes Scores and Reoperations After the Bernese Periacetabular Osteotomy?

Beaulé

Dowding

Parker

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background The Bernese periacetabular osteotomy (PAO) has entered its fourth decade and is frequently used for corrective osteotomy in patients with acetabular dysplasia. Although our capacity to preserve the joint after corrective osteotomy is excellent, gaining a better understanding on how well patients function after this surgery is important as well. Questions/purposes (1) What changes in patient-reported outcomes scores occur in patients treated with PAO for hip dysplasia in the setting of a single-surgeon practice? (2) What are the predictors of clinical function and survivorship? Methods All 67 patients presenting to a single surgeon's clinic with hip dysplasia treated with PAO between October 2005 and January 2013 were prospectively followed. Baseline demographic data as well as pre-and postoperative radiographic and functional measurements were obtained with a minimum of 1-year followup. Radiographic criteria included Tönnis grade, Tönnis angle, minimum joint space width, center-edge angle, presence of crossover sign, medial translation of the hip center, and alpha angle. We also used validated outcome measures including the WOMAC, the UCLA Activity Scale, and the SF-12. Multiple regression analysis was used to determine predictors of functional outcome scores. Results There were increases in WOMAC, UCLA, and SF-12 Physical scores. Higher preoperative alpha angle was associated with a lower postoperative WOMAC score (b = À0.47; 95% confidence interval [CI], À0.92 to À0.02; R 2 = 0.08; p = 0.04). The 5-year Kaplan-Meier survivorship was 94.1% (95% CI, 90.7-97.5) with reoperation (ie, hip arthroscopy and/or total hip arthroplasty) used as the endpoint for failure. With the limited numbers available, we could not identify any demographic or radiographic factors associated with reoperation. Conclusions Overall survivorship for the PAO at our center at 5 years is comparable to other clinical series with overall functional scores improving. A greater alpha angle preoperatively was associated with poorer patient-reported outcome scores. Further research is needed to determine how and when intraarticular cartilage damage associated with dysplasia needs to be addressed. Level of Evidence Level IV, therapeutic study.

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“…As the concept of femoroacetabular impingement (FAI) has become accepted [23], more hip problems are being treated with joint preservation surgeries [5,46,61]. These advances in hip preservation are fueled by better diagnostics and technical improvements in both hip arthroscopy Each author certifies that he or she, or a member of his or her immediate family, has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.…”

Section: Introductionmentioning

confidence: 99%

“…The majority of focal cartilage lesions caused by FAI are located on the acetabulum [23,46,62], although femoral head defects are not infrequent [40,54]. Acetabular cartilage defects are often treated by débridement of loose flaps, rim trimming, and microfracture of the remaining defect.…”

Section: Introductionmentioning

confidence: 99%