PMID- 34767088
OWN - NLM
STAT- MEDLINE
DCOM- 20220916
LR  - 20220916
IS  - 1434-3916 (Electronic)
IS  - 0936-8051 (Linking)
VI  - 142
IP  - 10
DP  - 2022 Oct
TI  - Arthroscopic surgery for femoroacetabular impingement has limited effect in 
      patients with Tonnis grade-2 at 4-year follow-up.
PG  - 2801-2809
LID - 10.1007/s00402-021-04249-5 [doi]
AB  - INTRODUCTION: This study evaluated intraoperative findings and outcomes in Tonnis 
      grade-2 patients after hip arthroscopy and compared these results with patients 
      with Tonnis grade-0 and grade-1. MATERIALS AND METHODS: Retrospective cohort 
      study of patients undergoing hip arthroscopy between January 2013 and December 
      2017. Patients were divided into either Tonnis grade-2, grade-1, and grade-0 
      osteoarthritis groups. Labral and chondral status were evaluated. Radiographic 
      analysis, modified Harris hip score (mHHS), a self-administered Hip Outcome Score 
      (HOS) questionnaire, with activity of daily living (ADL) and sports subscale 
      (SSS), and a self-administered short version of the International Hip Outcome 
      Tool (IHOT-12) were assessed at 6, 12 months, and then yearly. Clinical 
      meaningful outcomes were measured with the minimal clinical important difference 
      (MCID), patient acceptable symptom state (PASS), and substantial clinical benefit 
      (SCB) for mHHS, HOS-ADL and HOS-SSS, and IHOT-12. RESULTS: A total of 264 hip 
      arthroscopic procedures met the inclusion criteria. There were 38 patients Tonnis 
      grade-2, 91 patients Tonnis grade-1, and 135 patients Tonnis grade-0. Mean 
      follow-up was 48.7 months in Tonnis grade-2 group, 48.6 months in Tonnis grade-0 
      group, and 48.1 months in Tonnis grade-1 group. Tonnis grade-2 patients had more 
      extensive rim chondral damage, and a higher rate of labral debridement was 
      performed in this group. There were no statistically significant differences in 
      preoperative PROs among the groups. Tonnis grade-2 group had statistically 
      significant improvement in mHHS, but not in HOS-AVD, HOS-SSS and IHOT-12. Between 
      T1 and T2 groups there were no statistically significant differences in outcomes. 
      Lower significant percentage values of Tonnis grade-2 patients achieved MCID, 
      PASS, and SCB threshold. CONCLUSION: Improvements in PROs and rates of achieving 
      clinical meaningful outcomes were limited for patients with Tonnis grade-2 after 
      HA at 4-year follow-up. The outcomes of the Tonnis grade-2 cohort deteriorate 
      over mid-term follow-up. Our results could be used in orthopedic practice to 
      inform patients about the limited role of hip arthroscopy as a joint preservation 
      procedure in these selected patients. LEVEL OF EVIDENCE: Cohort study, level 3.
CI  - (c) 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, 
      part of Springer Nature.
FAU - Mas Martinez, Jesus
AU  - Mas Martinez J
AD  - Hip Unit, Department of Orthopedic Surgery, Clinica HLA Vistahermosa, Av de Denia 
      76, 03016, Alicante, Spain.
FAU - Verdu-Roman, Carmen
AU  - Verdu-Roman C
AD  - Hip Unit, Department of Orthopedic Surgery, Clinica HLA Vistahermosa, Av de Denia 
      76, 03016, Alicante, Spain.
FAU - Bustamante Suarez de Puga, David
AU  - Bustamante Suarez de Puga D
AD  - Hip Unit, Department of Orthopedic Surgery, Clinica HLA Vistahermosa, Av de Denia 
      76, 03016, Alicante, Spain.
FAU - Morales Santias, Manuel
AU  - Morales Santias M
AD  - Hip Unit, Department of Orthopedic Surgery, Clinica HLA Vistahermosa, Av de Denia 
      76, 03016, Alicante, Spain.
FAU - Martinez Gimenez, Enrique
AU  - Martinez Gimenez E
AD  - Hip Unit, Department of Orthopedic Surgery, Clinica HLA Vistahermosa, Av de Denia 
      76, 03016, Alicante, Spain.
FAU - Sanz-Reig, Javier
AU  - Sanz-Reig J
AUID- ORCID: 0000-0002-8276-7402
AD  - Hip Unit, Department of Orthopedic Surgery, Clinica HLA Vistahermosa, Av de Denia 
      76, 03016, Alicante, Spain. jsanz@traumavist.com.
LA  - eng
PT  - Journal Article
DEP - 20211112
PL  - Germany
TA  - Arch Orthop Trauma Surg
JT  - Archives of orthopaedic and trauma surgery
JID - 9011043
SB  - IM
MH  - Activities of Daily Living
MH  - Arthroscopy/methods
MH  - Cohort Studies
MH  - *Femoracetabular Impingement/surgery
MH  - Follow-Up Studies
MH  - Hip Joint/surgery
MH  - Humans
MH  - Retrospective Studies
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Clinically meaningful outcomes
OT  - Hip arthroscopy
OT  - Minimal clinical important difference
OT  - Patient-reported outcome score
OT  - Tonnis grade
EDAT- 2021/11/13 06:00
MHDA- 2022/09/17 06:00
CRDT- 2021/11/12 12:22
PHST- 2021/02/04 00:00 [received]
PHST- 2021/11/02 00:00 [accepted]
PHST- 2021/11/13 06:00 [pubmed]
PHST- 2022/09/17 06:00 [medline]
PHST- 2021/11/12 12:22 [entrez]
AID - 10.1007/s00402-021-04249-5 [pii]
AID - 10.1007/s00402-021-04249-5 [doi]
PST - ppublish
SO  - Arch Orthop Trauma Surg. 2022 Oct;142(10):2801-2809. doi: 
      10.1007/s00402-021-04249-5. Epub 2021 Nov 12.