PMID- 32374634
OWN - NLM
STAT- MEDLINE
DCOM- 20201109
LR  - 20201109
IS  - 1552-3365 (Electronic)
IS  - 0363-5465 (Linking)
VI  - 48
IP  - 7
DP  - 2020 Jun
TI  - 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.
PG  - 1625-1635
LID - 10.1177/0363546520914604 [doi]
AB  - 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, Tonnis 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.
FAU - Maldonado, David R
AU  - Maldonado DR
AD  - American Hip Institute Research Foundation, Des Plaines, Illinois, USA.
FAU - Chen, Jeffery W
AU  - Chen JW
AD  - School of Medicine, Vanderbilt University, Nashville, Tennessee, USA.
FAU - Yelton, Mitchell J
AU  - Yelton MJ
AD  - American Hip Institute Research Foundation, Des Plaines, Illinois, USA.
FAU - Rosinsky, Philip J
AU  - Rosinsky PJ
AD  - American Hip Institute Research Foundation, Des Plaines, Illinois, USA.
FAU - Shapira, Jacob
AU  - Shapira J
AD  - American Hip Institute Research Foundation, Des Plaines, Illinois, USA.
FAU - Brayboy, Ciaran
AU  - Brayboy C
AD  - American Hip Institute Research Foundation, Des Plaines, Illinois, USA.
FAU - Lall, Ajay C
AU  - Lall AC
AD  - American Hip Institute Research Foundation, Des Plaines, Illinois, USA.
AD  - American Hip Institute, Des Plaines, Illinois, USA.
FAU - Domb, Benjamin G
AU  - Domb BG
AD  - American Hip Institute Research Foundation, Des Plaines, Illinois, USA.
AD  - American Hip Institute, Des Plaines, Illinois, USA.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20200506
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  - *Arthroscopy
MH  - Case-Control Studies
MH  - *Femoracetabular Impingement/surgery
MH  - Follow-Up Studies
MH  - Hip Joint/surgery
MH  - Humans
MH  - Joint Instability/*surgery
MH  - Patient Satisfaction
MH  - Retrospective Studies
MH  - Treatment Outcome
OTO - NOTNLM
OT  - femoroacetabular impingement
OT  - hip arthroscopy
OT  - ligamentous laxity
OT  - microinstability
OT  - patient-reported outcomes
EDAT- 2020/05/07 06:00
MHDA- 2020/11/11 06:00
CRDT- 2020/05/07 06:00
PHST- 2020/05/07 06:00 [pubmed]
PHST- 2020/11/11 06:00 [medline]
PHST- 2020/05/07 06:00 [entrez]
AID - 10.1177/0363546520914604 [doi]
PST - ppublish
SO  - Am J Sports Med. 2020 Jun;48(7):1625-1635. doi: 10.1177/0363546520914604. Epub 
      2020 May 6.