PMID- 28820272
OWN - NLM
STAT- MEDLINE
DCOM- 20180222
LR  - 20220331
IS  - 1552-3365 (Electronic)
IS  - 0363-5465 (Linking)
VI  - 45
IP  - 13
DP  - 2017 Nov
TI  - A Comparison of Clinical Outcomes After Unilateral or Bilateral Hip Arthroscopic 
      Surgery: Age- and Sex-Matched Cohort Study.
PG  - 3044-3051
LID - 10.1177/0363546517719020 [doi]
AB  - BACKGROUND: A significant number of patients undergoing hip arthroscopic surgery 
      for femoroacetabular impingement (FAI) have bilateral deformities and may require 
      surgery for both hips. PURPOSE: To compare outcomes between patients who 
      underwent bilateral hip arthroscopic surgery to a matched cohort of patients who 
      underwent unilateral hip arthroscopic surgery. STUDY DESIGN: Cohort study; Level 
      of evidence, 3. METHODS: A consecutive series of patients who underwent primary 
      hip arthroscopic surgery for FAI by a single fellowship-trained surgeon from 
      January 2012 to January 2014 and had a minimum follow-up of 2 years were 
      evaluated. Patients who underwent staged bilateral hip arthroscopic surgery were 
      identified and matched 1:2 to patients who underwent unilateral hip arthroscopic 
      surgery based on age, sex, and body mass index (BMI). Demographic, preoperative, 
      and postoperative variables were compared between the groups. RESULTS: 
      Forty-three patients in the bilateral group were matched with 86 patients in the 
      unilateral group based on sex (24 female [56%] vs 48 female [56%], respectively; 
      P > .99), age (28.6 +/- 10.8 years vs 28.9 +/- 10.8 years, respectively; P = .88), 
      and BMI (24.8 +/- 5.8 kg/m(2) vs 24.8 +/- 4.0 kg/m(2), respectively; P = .98). There 
      were no significant preoperative demographic or radiographic differences between 
      the groups. Both groups demonstrated significant preoperative to postoperative 
      improvements in the Hip Outcome Score-Activities of Daily Living (HOS-ADL), Hip 
      Outcome Score-Sports Subscale (HOS-SS), and modified Harris Hip Score (mHHS) ( P 
      < .0001 for all). When compared with patients in the unilateral group, patients 
      who underwent bilateral hip arthroscopic surgery had less improvement in mHHS and 
      pain scores. Sixty-five (76%) patients in the unilateral group achieved the 
      minimum clinically important difference (MCID) for the mHHS compared with 21 
      (49%) in the bilateral group ( P = .03), while 64 (74%) patients achieved the 
      patient acceptable symptomatic state (PASS) for the mHHS compared with 22 (51%) 
      in the bilateral group ( P = .02). Patients in the bilateral group with greater 
      than 10 months between surgical procedures had lower postoperative HOS-ADL scores 
      ( P = .04) and lower improvement in pain and HOS-SS scores ( P < .0001 and P = 
      .05, respectively). CONCLUSION: Patients who underwent unilateral and bilateral 
      hip arthroscopic surgery for FAI had improved functional outcomes after 2 years. 
      However, patients who underwent bilateral hip arthroscopic surgery had less 
      improvement in their mHHS and pain scores compared with those who underwent 
      unilateral hip arthroscopic surgery but no differences in HOS-ADL, HOS-SS, or 
      satisfaction scores. Patients in the bilateral group with longer than 10 months 
      between surgical procedures had lower outcome scores than patients who underwent 
      their second surgical procedure within 10 months of their primary surgery.
FAU - Kuhns, Benjamin D
AU  - Kuhns BD
AD  - Department of Orthopaedics and Rehabilitation, University of Rochester Medical 
      Center, Rochester, New York, USA.
FAU - Hannon, Charles P
AU  - Hannon CP
AD  - Department of Orthopedic Surgery, Rush University Medical Center, Chicago, 
      Illinois, USA.
FAU - Makhni, Eric C
AU  - Makhni EC
AD  - Division of Sports Medicine, Department of Orthopedic Surgery, Henry Ford Health 
      System, Detroit, Michigan, USA.
FAU - Alter, Jennifer
AU  - Alter J
AD  - Department of Orthopedic Surgery, Rush University Medical Center, Chicago, 
      Illinois, USA.
FAU - Mather, Richard C 3rd
AU  - Mather RC 3rd
AD  - Duke University Medical Center, Durham, North Carolina, USA.
FAU - Salata, Michael J
AU  - Salata MJ
AD  - University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA.
FAU - Nho, Shane J
AU  - Nho SJ
AD  - Department of Orthopedic Surgery, Rush University Medical Center, Chicago, 
      Illinois, USA.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20170818
PL  - United States
TA  - Am J Sports Med
JT  - The American journal of sports medicine
JID - 7609541
SB  - IM
MH  - Activities of Daily Living
MH  - Adult
MH  - *Arthroscopy
MH  - Female
MH  - Femoracetabular Impingement/diagnostic imaging/*surgery
MH  - Follow-Up Studies
MH  - Hip Joint/*abnormalities/diagnostic imaging/*surgery
MH  - Humans
MH  - Male
MH  - Pain/prevention & control
MH  - Radiography
MH  - Sports
MH  - Treatment Outcome
OTO - NOTNLM
OT  - FAI
OT  - bilateral
OT  - hip arthroscopic surgery
OT  - patient acceptable symptomatic state (PASS)
EDAT- 2017/08/19 06:00
MHDA- 2018/02/23 06:00
CRDT- 2017/08/19 06:00
PHST- 2017/08/19 06:00 [pubmed]
PHST- 2018/02/23 06:00 [medline]
PHST- 2017/08/19 06:00 [entrez]
AID - 10.1177/0363546517719020 [doi]
PST - ppublish
SO  - Am J Sports Med. 2017 Nov;45(13):3044-3051. doi: 10.1177/0363546517719020. Epub 
      2017 Aug 18.