Outcomes of Hip Arthroscopic Surgery in Patients With Tönnis Grade 1 Osteoarthritis at a Minimum 5-Year Follow-up: A Matched-Pair Comparison With a Tönnis Grade 0 Control Group

Domb, Benjamin G.; Chaharbakhshi, Edwin O.; Rybalko, Danil; Close, Mary R.; Litrenta, Jody; Perets, Itay

doi:10.1177/0363546517706957

Cited by 98 publications

(86 citation statements)

References 30 publications

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“…Horisberger et al 22) identified that those with Tönnis grade III have poorer prognoses compared with those with Tönnis <III. Several other studies also suggested better prognosis in groups with lower Tönnis grades [23][24][25] and others identified an association between intraoperative cartilage degeneration and poor prognosis 10,26) . According to Philippon et al 27) , patients aged 50 years or older with joint space width of less than 2 mm needed THA 9.9 times more than younger patients.…”

Section: Discussionmentioning

confidence: 89%

Midterm-clinical Outcomes after Hip Arthroscopy in Middle-aged Patients with Early Osteoarthritis

et al. 2020

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In the context of increased life expectancy, the number of patients in older age groups aiming to live an active life has been on the rise, despite their higher risk of developing osteoarthritis and hip osteoarthritis specifically 1). Recently, due to quicker postoperative recovery, and pain reduction compared to open surgical procedures 2) , hip arthroscopy is gaining popularity as a hip-preserving surgical approach for those presenting with hip joint lesions 3-5). Hip arthroscopy in young patients has been proven as an effective treatment option 6-8) , while its effects in relatively

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Section: Discussionmentioning

confidence: 89%

Midterm-clinical Outcomes after Hip Arthroscopy in Middle-aged Patients with Early Osteoarthritis

et al. 2020

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“…The anteroposterior supine view was used to assess the following: the LCEA of Wiberg 83 as modified by Ogata et al, 61 the level of osteoarthritis as graded with the Tönnis system, 20 acetabular version as measured by the presence of crossover, and ischial spine and posterior wall signs. 45 Cam deformity was assessed on the 45° Dunn lateral view by measuring the alpha angle and the head-neck offset and defined as an alpha angle >55°.…”

Section: Methodsmentioning

confidence: 99%

“…29 Postoperative patient satisfaction on a scale from 0 to 10 and surgical complications were also recorded. The percentage of patients achieving the patient acceptable symptomatic state (PASS) and minimal clinically important difference (MCID) was found for the mHHS (PASS, ≥74 points; MCID, delta [Δ] ≥8 points) 20,21 and the HOS-SSS 10 (PASS, ≥65 points; MCID, Δ≥6 points). Additionally, the PASS of iHOT-12 (≥63 points) was calculated.…”

Section: Methodsmentioning

confidence: 99%

Achieving Successful Outcomes of Hip Arthroscopy in the Setting of Generalized Ligamentous Laxity With Labral Preservation and Appropriate Capsular Management: A Propensity Matched Controlled Study

et al. 2020

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Background: Association among generalized ligamentous laxity (GLL), hip microinstability, and patient-reported outcomes (PROs) after hip arthroscopy has yet to be completely established. Purposes: (1) To report minimum 2-year PROs in patients with GLL who underwent hip arthroscopy in the setting of symptomatic labral tears and femoroacetabular impingement syndrome and (2) to compare clinical results with a matched-pair control group without GLL. Study Design: Cohort study; Level of evidence, 3. Methods: Data from a prospectively collected database were retrospectively reviewed between August 2014 and December 2016. Patients were considered eligible if they received primary arthroscopic treatment for symptomatic labral tears and femoroacetabular impingement. Inclusion criteria included preoperative and minimum 2-year follow-up scores for the following PROs: modified Harris Hip Score (mHHS), Non-arthritic Hip Score (NAHS), and visual analog scale for pain (VAS). From the sample population, 2 groups were created: the GLL group (Beighton score ≥4) and the control group (Beighton score <4). Patients were matched in a 1:2 ratio via propensity score matching according to age, sex, body mass index, Tönnis grade, and preoperative lateral center-edge angle. Patient acceptable symptomatic state (PASS) and minimal clinically important difference (MCID) for mHHS, Hip Outcome Score–Sports Specific Scale (HOS-SSS), and International Hip Outcome Tool–12 (iHOT-12) were calculated. Results: A total of 57 patients with GLL were matched to 88 control patients. Age, sex, body mass index, and follow-up times were not different between groups ( P > .05). Preoperative radiographic measurements demonstrated no difference between groups. Intraoperative findings and procedures between groups were similar except for capsular treatment, with the GLL group receiving a greater percentage of capsular plications ( P = .04). At minimum 2-year follow-up, both groups showed significant improvement in PROs and VAS ( P < .001). Furthermore, the postoperative PROs at minimum 2-year follow-up and the magnitude of improvement (delta value) were similar between groups for mHHS, NAHS, HOS-SSS, and VAS ( P > .05). Moreover, groups reached comparable rates of MCID and PASS for mHHS, HOS-SSS, and iHOT-12. Conclusion: Patients with GLL after hip arthroscopy for symptomatic femoroacetabular impingement and labral tears may expect favorable outcomes with appropriate labral and capsular management at minimum 2-year follow-up. When compared with a pair-matched control group without GLL, results were comparable for mHHS, NAHS, HOS-SSS, and VAS and reached PASS and/or MCID for mHHS, HOS-SSS, and iHOT-12.

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“…By contrast there is a general consensus that the efficacy of reconstructive hip surgery in patients with moderate joint space narrowing (i.e., Tönnis stage 2 of osteoarthritis 113 ) is limited and further decreases with age. [56][57][58]72,74,[114][115][116] In these patients the additional benefit of MR arthrography for treatment planning is doubtful, and noncontrast MRI should be considered. In patients with residual symptoms after intra-articular surgery, direct MR arthrography is recommended to assess re-tears of the labrum and capsular adhesions/defects.…”

Section: Mri Protocolmentioning

confidence: 99%

Conventional and Arthrographic Magnetic Resonance Techniques for Hip Evaluation: What the Radiologist Should Know

Schmaranzer

Cerezal

Llopis

2019

Semin Musculoskelet Radiol

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Over the last 2 decades, the definition of pathomechanical concepts that link osseous deformities to chondrolabral damage and expose young and active patients to the risk of early osteoarthritis has led to a tremendous increase in the number of joint-preserving surgeries performed. The rise in arthroscopic procedures has led to an increasing demand for comprehensive preoperative magnetic resonance imaging (MRI) assessment of the hip joint. This includes conventional MRI for the assessment of extra-articular and periarticular pathologies such as greater trochanteric pain, deep gluteal pain syndrome, and sports injuries. Magnetic resonance arthrography with or without traction is reserved for the accurate evaluation of deformities associated with impingement and hip instability and for detecting the resulting intra-articular lesions. This article summarizes the current standard imaging techniques that the radiologist should know. It also explores the potential of computer-assisted analysis of three-dimensional MRI for virtual impingement simulation and volumetric analysis of cartilage composition and geometry.

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Outcomes of Hip Arthroscopic Surgery in Patients With Tönnis Grade 1 Osteoarthritis at a Minimum 5-Year Follow-up: A Matched-Pair Comparison With a Tönnis Grade 0 Control Group

Cited by 98 publications

References 30 publications

Midterm-clinical Outcomes after Hip Arthroscopy in Middle-aged Patients with Early Osteoarthritis

Midterm-clinical Outcomes after Hip Arthroscopy in Middle-aged Patients with Early Osteoarthritis

Achieving Successful Outcomes of Hip Arthroscopy in the Setting of Generalized Ligamentous Laxity With Labral Preservation and Appropriate Capsular Management: A Propensity Matched Controlled Study

Conventional and Arthrographic Magnetic Resonance Techniques for Hip Evaluation: What the Radiologist Should Know

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