PMID- 33581300
OWN - NLM
STAT- MEDLINE
DCOM- 20210819
LR  - 20210819
IS  - 1526-3231 (Electronic)
IS  - 0749-8063 (Linking)
VI  - 37
IP  - 7
DP  - 2021 Jul
TI  - Concomitant Lumbar Spinal Stenosis Negatively Affects Outcomes After Hip 
      Arthroscopy for Femoroacetabular Impingement.
PG  - 2102-2109
LID - S0749-8063(21)00132-8 [pii]
LID - 10.1016/j.arthro.2021.01.068 [doi]
AB  - PURPOSE: The purpose of this study was to assess the prognostic effect of lumbar 
      spinal stenosis on clinical outcomes after hip arthroscopy for femoroacetabular 
      impingement syndrome (FAI). METHODS: Patients undergoing hip arthroscopy between 
      September 2009 and December 2015 for FAI with concomitant lumbar spinal stenosis 
      (central/neuroforaminal) and a 2-year follow-up were identified (hip-spine). A 
      1:1 case-matching query using preoperative modified Harris Hip Score (mHHS) 
      within 3 points, body mass index (BMI) within 3 points, age within 5 years, and 
      sex identified a control cohort without spinal pathology. Follow-up 
      patient-reported outcomes (PROs) and clinical failure rates to revision procedure 
      were compared using analysis of variance (ANOVA) and Kaplan-Meier survival 
      analysis. RESULTS: Twenty-six patients met criteria of the hip-spine group (age: 
      45.9 +/- 12.2 years; BMI: 27.3 +/- 5.0 kg/m(2), baseline mHHS: 44.17 +/- 2.76) vs the 
      control group (age: 46.2 +/- 12.4 years, P = .94; BMI: 26.7 +/- 4.1 kg/m(2), P = .61; 
      baseline mHHS: 44.27 +/- 2.82, P = .98). ANOVA analysis demonstrated that all PROs 
      improved from baseline to 2-year outcomes (P < .001). The hip-spine vs control 
      group had lower 1-year (mHHS: 65.97 +/- 5.64 vs 85.04 +/- 3.09, P = .006; 
      nonarthritic hip score (NAHS): 70.26 +/- 5.71 vs 87.89 +/- 2.65, P = .010) and 2-year 
      (mHHS: 69.72 +/- 4.92 vs 84.71 +/- 2.56, P = .007; NAHS: 72.23 +/- 5.18 vs 87.14 +/- 
      2.23, P = .008) outcomes. While there was no difference in patient acceptable 
      symptomatic state (PASS) and minimal clinically important difference (MCID) rates 
      at 1-year follow-up, the hip-spine group demonstrated lower PASS (42% vs 81%, P = 
      .004) and MCID (58% vs 88%, P = .027) rates at 2 years. Although susceptible to 
      type II error, there was no difference in clinical failure rates to revision 
      procedure (P = .13). CONCLUSIONS: While net PROs from baseline improve after hip 
      arthroscopy for FAI, the presence of concomitant lumbar spinal stenosis 
      negatively affects postoperative PROs. FAI patients with spinal stenosis should 
      be counseled accordingly. LEVEL OF EVIDENCE: Level III, case-control study.
CI  - Copyright (c) 2021 Arthroscopy Association of North America. Published by Elsevier 
      Inc. All rights reserved.
FAU - Akpinar, Berkcan
AU  - Akpinar B
AD  - NYU Langone Orthopedic Hospital, New York, New York, U.S.A.. Electronic address: 
      Berkcan.Akpinar@nyulangone.org.
FAU - Lin, Lawrence J
AU  - Lin LJ
AD  - NYU Langone Orthopedic Hospital, New York, New York, U.S.A.
FAU - Bloom, David A
AU  - Bloom DA
AD  - NYU Langone Orthopedic Hospital, New York, New York, U.S.A.
FAU - Youm, Thomas
AU  - Youm T
AD  - NYU Langone Orthopedic Hospital, New York, New York, U.S.A.
LA  - eng
PT  - Journal Article
DEP - 20210210
PL  - United States
TA  - Arthroscopy
JT  - Arthroscopy : the journal of arthroscopic & related surgery : official 
      publication of the Arthroscopy Association of North America and the International 
      Arthroscopy Association
JID - 8506498
SB  - IM
CIN - Arthroscopy. 2021 Jul;37(7):2110-2111. PMID: 34226003
MH  - Activities of Daily Living
MH  - Arthroscopy
MH  - Case-Control Studies
MH  - Child, Preschool
MH  - *Femoracetabular Impingement/surgery
MH  - Follow-Up Studies
MH  - Hip Joint/surgery
MH  - Humans
MH  - Middle Aged
MH  - Patient Reported Outcome Measures
MH  - *Spinal Stenosis/complications/surgery
MH  - Treatment Outcome
EDAT- 2021/02/14 06:00
MHDA- 2021/08/20 06:00
CRDT- 2021/02/13 20:10
PHST- 2020/07/08 00:00 [received]
PHST- 2021/01/18 00:00 [revised]
PHST- 2021/01/25 00:00 [accepted]
PHST- 2021/02/14 06:00 [pubmed]
PHST- 2021/08/20 06:00 [medline]
PHST- 2021/02/13 20:10 [entrez]
AID - S0749-8063(21)00132-8 [pii]
AID - 10.1016/j.arthro.2021.01.068 [doi]
PST - ppublish
SO  - Arthroscopy. 2021 Jul;37(7):2102-2109. doi: 10.1016/j.arthro.2021.01.068. Epub 
      2021 Feb 10.