PMID- 31411901
OWN - NLM
STAT- MEDLINE
DCOM- 20200525
LR  - 20200525
IS  - 1552-3365 (Electronic)
IS  - 0363-5465 (Linking)
VI  - 47
IP  - 11
DP  - 2019 Sep
TI  - Prevalence and Clinical Implications of Chondral Injuries After Hip Arthroscopic 
      Surgery for Femoroacetabular Impingement Syndrome.
PG  - 2626-2635
LID - 10.1177/0363546519865912 [doi]
AB  - BACKGROUND: Studies on the effect of partial- and full-thickness chondral damage 
      of the hip on outcomes and the ability to achieve meaningful clinical outcomes 
      are limited. PURPOSE: To determine the effect of full- and partial-thickness 
      chondral injuries on 2-year outcomes in patients undergoing hip arthroscopic 
      surgery for femoroacetabular impingement syndrome (FAIS) compared with patients 
      without chondral damage, and to identify significant predictors of achieving the 
      patient acceptable symptomatic state (PASS) and minimal clinically important 
      difference (MCID). STUDY DESIGN: Case-control study; Level of evidence, 3. 
      METHODS: Data from consecutive patients with evidence of chondromalacia at the 
      time of primary hip arthroscopic surgery with routine capsular closure for the 
      treatment of FAIS by a single fellowship-trained surgeon between January 2012 and 
      September 2016 were reviewed. Patients were divided into groups with 
      partial-thickness (grade I-III) or full-thickness (grade IV) chondral defects and 
      matched by age and body mass index (BMI) to patients without chondral injuries. 
      Preoperative and postoperative outcomes were compared among the 3 groups, and a 
      binary logistic regression analysis was utilized to identify significant 
      predictors of achieving the MCID and PASS. RESULTS: There were 634 patients 
      included in the analysis, with a mean age of 34.5 +/- 10.9 years and a mean BMI of 
      25.2 +/- 4.7 kg/m(2). A total of 493 (77.8%) patients had no evidence of chondral 
      damage, 92 (14.5%) patients had partial-thickness chondral defects, and 49 (7.7%) 
      patients had full-thickness chondral defects. There were statistically 
      significant differences in the Hip Outcome Score (HOS)-Activities of Daily 
      Living, HOS-Sports Subscale, modified Harris Hip Score, pain, and satisfaction (P 
      < .01) among the 3 groups. Patients with grade IV chondromalacia experienced the 
      poorest outcomes and lowest percentage of achieving the PASS. Predictors for 
      achieving any PASS threshold included preoperative alpha angle (odds ratio [OR], 
      0.96; P = .016), absence of preoperative limping (OR, 7.25; P = .002), absence of 
      preoperative chronic pain (OR, 5.83; P = .019), primary hip arthroscopic surgery 
      (OR, 0.17; P = .050), patients who self-identified as runners (OR, 2.27; P = 
      .037), and Tonnis grade 0 (OR, 2.86; P = .032). Male sex (OR, 2.49; P = .015) was 
      the only predictor of achieving any MCID threshold. CONCLUSION: Patients with 
      grade IV chondral defects experienced worse functional outcomes, lower 
      satisfaction, and increased pain when compared with both patients without 
      chondral damage or grade I-III chondromalacia at 2-year follow-up. Several 
      predictors were associated with achieving clinically significant function in 
      patients undergoing hip arthroscopic surgery for FAIS.
FAU - Chahla, Jorge
AU  - Chahla J
AD  - Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of 
      Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, USA.
FAU - Beck, Edward C
AU  - Beck EC
AD  - Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of 
      Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, USA.
FAU - Okoroha, Kelechi
AU  - Okoroha K
AD  - Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of 
      Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, USA.
FAU - Cancienne, Jourdan M
AU  - Cancienne JM
AD  - Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of 
      Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, USA.
FAU - Kunze, Kyle N
AU  - Kunze KN
AD  - Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of 
      Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, USA.
FAU - Nho, Shane J
AU  - Nho SJ
AD  - Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of 
      Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, USA.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20190814
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  - Cartilage Diseases/*physiopathology
MH  - Case-Control Studies
MH  - Female
MH  - Femoracetabular Impingement/*surgery
MH  - Hip Joint/*surgery
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Minimal Clinically Important Difference
MH  - Postoperative Period
MH  - Prevalence
MH  - Treatment Outcome
MH  - Young Adult
OTO - NOTNLM
OT  - chondromalacia
OT  - femoroacetabular impingement
OT  - hip
OT  - minimal clinically important difference
OT  - patient acceptable symptomatic state
EDAT- 2019/08/15 06:00
MHDA- 2020/05/26 06:00
CRDT- 2019/08/15 06:00
PHST- 2019/08/15 06:00 [pubmed]
PHST- 2020/05/26 06:00 [medline]
PHST- 2019/08/15 06:00 [entrez]
AID - 10.1177/0363546519865912 [doi]
PST - ppublish
SO  - Am J Sports Med. 2019 Sep;47(11):2626-2635. doi: 10.1177/0363546519865912. Epub 
      2019 Aug 14.