High prevalence of hip lesions secondary to arthroscopic over- or undercorrection of femoroacetabular impingement in patients with postoperative pain View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2021-11-29

AUTHORS

Malin K. Meier, Till D. Lerch, Simon D. Steppacher, Klaus A. Siebenrock, Moritz Tannast, Peter Vavron, Ehrenfried Schmaranzer, Florian Schmaranzer

ABSTRACT

ObjectivesTo compare the prevalence of pre- and postoperative osseous deformities and intra-articular lesions in patients with persistent pain following arthroscopic femoroacetabular impingement (FAI) correction and to identify imaging findings associated with progressive cartilage damage.MethodsRetrospective study evaluating patients with hip pain following arthroscopic FAI correction between 2010 and 2018. Pre- and postoperative imaging studies were analyzed independently by two blinded readers for osseous deformities (cam-deformity, hip dysplasia, acetabular overcoverage, femoral torsion) and intra-articular lesions (chondro-labral damage, capsular lesions). Prevalence of osseous deformities and intra-articular lesions was compared with paired t-tests/McNemar tests for continuous/dichotomous data. Association between imaging findings and progressive cartilage damage was assessed with logistic regression.ResultsForty-six patients (mean age 29 ± 10 years; 30 female) were included. Postoperatively, 74% (34/46) of patients had any osseous deformity including 48% (22/46) acetabular and femoral deformities. Ninety-six percent (44/46) had an intra-articular lesion ranging from 20% (9/46) for femoral to 65% (30/46) for acetabular cartilage lesions. Prevalence of hip dysplasia increased (2 to 20%, p = 0.01) from pre- to postoperatively while prevalence of cam-deformity decreased (83 to 28%, p < 0.001).Progressive cartilage damage was detected in 37% (17/46) of patients and was associated with extensive preoperative cartilage damage > 2 h, i.e., > 60° (OR 7.72; p = 0.02) and an incremental increase in postoperative alpha angles (OR 1.18; p = 0.04).ConclusionPrevalence of osseous deformities secondary to over- or undercorrrection was high. Extensive preoperative cartilage damage and higher postoperative alpha angles increase the risk for progressive degeneration.Key Points• The majority of patients presented with osseous deformities of the acetabulum or femur (74%) and with intra-articular lesions (96%) on postoperative imaging.• Prevalence of hip dysplasia increased (2 to 20%, p = 0.01) from pre- to postoperatively while prevalence of a cam deformity decreased (83 to 28%, p < 0.001).• Progressive cartilage damage was present in 37% of patients and was associated with extensive preoperative cartilage damage > 2 h (OR 7.72; p = 0.02) and with an incremental increase in postoperative alpha angles (OR 1.18; p = 0.04). More... »

PAGES

3097-3111

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00330-021-08398-4

DOI

http://dx.doi.org/10.1007/s00330-021-08398-4

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1143452727

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/34842955


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35 FAI correction
36 McNemar test
37 MethodsRetrospective
38 ObjectivesTo
39 ResultsForty-six patients
40 acetabular cartilage lesions
41 acetabulum
42 alpha angle
43 angle
44 arthroscopic
45 arthroscopic FAI correction
46 arthroscopic femoroacetabular impingement correction
47 association
48 blinded readers
49 cam deformity
50 cartilage damage
51 cartilage lesions
52 correction
53 damage
54 data
55 deformity
56 degeneration
57 dichotomous data
58 dysplasia
59 femoral deformity
60 femoroacetabular impingement
61 femur
62 findings
63 high prevalence
64 hip dysplasia
65 hip lesions
66 hip pain
67 imaging
68 imaging studies
69 impingement
70 impingement correction
71 increase
72 incremental increase
73 intra-articular lesions
74 lesions
75 logistic regression
76 majority
77 majority of patients
78 osseous deformities
79 pain
80 patients
81 percent
82 persistent pain
83 postoperative alpha angle
84 postoperative imaging
85 postoperative imaging studies
86 postoperative pain
87 pre
88 prevalence
89 prevalence of pre
90 progressive cartilage damage
91 progressive degeneration
92 readers
93 regression
94 risk
95 study
96 test
97 undercorrection
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