PMID- 32343594
OWN - NLM
STAT- MEDLINE
DCOM- 20201109
LR  - 20210520
IS  - 1552-3365 (Electronic)
IS  - 0363-5465 (Linking)
VI  - 48
IP  - 7
DP  - 2020 Jun
TI  - A Multicenter Study of Radiographic Measures Predicting Failure of Arthroscopy in 
      Borderline Hip Dysplasia: Beware of the Tonnis Angle.
PG  - 1608-1615
LID - 10.1177/0363546520914942 [doi]
AB  - BACKGROUND: Hip arthroscopy has been previously demonstrated to be an effective 
      treatment for adult mild hip dysplasia. There are many radiographic parameters 
      used to classify hip dysplasia, but to date few studies have demonstrated which 
      parameters are of most importance for predicting surgical outcomes. PURPOSE: To 
      identify preoperative radiographic parameters that are associated with poor 
      outcomes in the arthroscopic treatment of adult mild hip dysplasia. STUDY DESIGN: 
      Case-control study; Level of evidence, 3. METHODS: Radiographic analysis was 
      performed in patients with mild hip dysplasia who underwent arthroscopic surgery 
      between 2009 and 2015. Preoperative radiographic measurements included lateral 
      center edge angle, Tonnis angle, neck shaft angle, anterior center edge angle, 
      alpha angle, femoral head extrusion index, and acetabular depth-to-width ratio. 
      Failure was defined as failure to achieve the minimal clinically important 
      difference (MCID) utilizing the modified Harris Hip Score or as the need for 
      secondary operation. The equal variance t test was used to analyze radiographic 
      parameters. Statistical significance was determined using a P value of .05. 
      RESULTS: A total of 373 hips underwent analysis with an average follow-up of 41 
      months (range, 24-102 months). Of these, 46 hips (12%) required secondary 
      operation, and 95 (25%) failed to meet the MCID. The overall failure rate was 
      32.4%. There was no single measurement or combination thereof associated with 
      failure to reach the MCID. Higher preoperative Tonnis angles were associated with 
      secondary operation, with a mean of 6.7 degrees  (95% CI, 5.3 degrees -8.1 degrees ) in the secondary 
      operation group versus 4.8 degrees  (95% CI, 4.4 degrees -5.3 degrees ) in the nonsecondary operation 
      group (P = .006). The odds ratio was 1.12 (95% CI, 1.0-1.2; P = .05) per degree 
      increase in Tonnis angle for secondary operation. In patients with a Tonnis angle 
      >10 degrees , 84% required secondary operation. CONCLUSION: Higher Tonnis angles portend 
      a higher risk for revision surgery. The probability of secondary operation was 
      increased by a magnitude of 1.12 with each degree increase in the Tonnis angle. 
      In patients with a Tonnis angle >10 degrees , 84% required a secondary operation.
FAU - McQuivey, Kade S
AU  - McQuivey KS
AD  - Department of Orthopedics, Mayo Clinic Arizona, Phoenix, Arizona, USA.
FAU - Secretov, Erwin
AU  - Secretov E
AD  - Department of Orthopedics, University of Illinois, Chicago, Illinois, USA.
FAU - Domb, Benjamin G
AU  - Domb BG
AD  - Department of Orthopedics, American Hip Institute, Des Plaines, Illinois, USA.
FAU - Levy, Bruce A
AU  - Levy BA
AD  - Department of Orthopedics, Mayo Clinic, Rochester, Minnesota, USA.
FAU - Krych, Aaron J
AU  - Krych AJ
AD  - Department of Orthopedics, Mayo Clinic, Rochester, Minnesota, USA.
FAU - Neville, Matthew
AU  - Neville M
AD  - Department of Orthopedics, Mayo Clinic Arizona, Phoenix, Arizona, USA.
FAU - Hartigan, David E
AU  - Hartigan DE
AD  - Department of Orthopedic Surgery, Twin Cities Orthopedics, Minneapolis, 
      Minnesota, USA.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20200428
PL  - United States
TA  - Am J Sports Med
JT  - The American journal of sports medicine
JID - 7609541
SB  - IM
CIN - Am J Sports Med. 2021 Feb;49(2):NP10-NP12. PMID: 33523757
CIN - Am J Sports Med. 2021 Feb;49(2):NP9-NP10. PMID: 33523758
CIN - Am J Sports Med. 2021 May;49(6):NP19-NP20. PMID: 33929881
CIN - Am J Sports Med. 2021 May;49(6):NP20-NP22. PMID: 33929887
MH  - Acetabulum
MH  - Adult
MH  - *Arthroscopy
MH  - Case-Control Studies
MH  - *Hip Dislocation/diagnostic imaging/surgery
MH  - Hip Joint/diagnostic imaging/surgery
MH  - Humans
MH  - Retrospective Studies
MH  - Treatment Failure
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Tonnis angle
OT  - hip arthroscopy
OT  - hip dysplasia
OT  - lateral center edge angle
EDAT- 2020/04/29 06:00
MHDA- 2020/11/11 06:00
CRDT- 2020/04/29 06:00
PHST- 2020/04/29 06:00 [pubmed]
PHST- 2020/11/11 06:00 [medline]
PHST- 2020/04/29 06:00 [entrez]
AID - 10.1177/0363546520914942 [doi]
PST - ppublish
SO  - Am J Sports Med. 2020 Jun;48(7):1608-1615. doi: 10.1177/0363546520914942. Epub 
      2020 Apr 28.