PMID- 35247511 OWN - NLM STAT- MEDLINE DCOM- 20221005 LR - 20221102 IS - 1526-3231 (Electronic) IS - 0749-8063 (Linking) VI - 38 IP - 10 DP - 2022 Oct TI - Hip Arthroscopic Microfracture Augmented With Platelet-Rich Plasma-Infused Micronized Cartilage Allograft Significantly Improves Functional Outcomes. PG - 2819-2826.e1 LID - S0749-8063(22)00142-6 [pii] LID - 10.1016/j.arthro.2022.02.021 [doi] AB - PURPOSE: To evaluate functional outcomes and survivorship in patients at 1 year after undergoing arthroscopic microfracture augmented with hyaline allograft for symptomatic chondral defects of the hip. METHODS: Consecutive patients with and without prior hip procedures presenting with Outerbridge grade IV chondral lesion of the acetabulum or femoral head were prospectively followed. Patients underwent hip microfracture augmented with hyaline allograft suspended in autologous platelet-rich plasma between October 2016 and April 2018. Extent of cartilage degeneration was quantified using the chondromalacia severity index (CMI). Patient functional scores, including Tegner, Hip Outcome Score-Activities of Daily Living (HOS-ADL), Sport-Specific Subscale (HOS-SSS), modified Harris Hip Score (mHHS), and Nonarthritic Hip Score (NAHS) were collected preoperatively and at minimum 1-year postoperatively. Minimal clinically important difference (MCID) was analyzed. Statistical significance was established at P < .05. Pearson's coefficient analysis was performed to identify preoperative variables correlated with clinical outcomes. RESULTS: Fifty-seven patients (86.4%) had minimum 1-year follow-up and were included in the final analysis, with a mean age and body mass index (BMI) of 38.3 +/- 9.1 years and 27.7 +/- 4.9 kg/m(2), respectively. Comparison of baseline and postoperative score averages demonstrated significant improvements in Tegner scores (3.7 +/- 2.9 vs 5.1 +/- 2.6; P = .003), HOS-ADL (63.3 +/- 16.4 vs 89.1 +/- 14.5; P < .001), HOS-SSS (40.8 +/- 20.4 vs 79.5 +/- 21.6; P < .001), mHHS (61.5 +/- 16.2 vs 87.0 +/- 17.7; P < .001), and NAHS (56.6 +/- 14.9 vs 78.7 +/- 18.3; P < .001). The percentage of patients who achieved MCID for HOS-ADL, HOS-SSS, mHHS, and NAHS were 89.8%, 83.0%, 75.6%, and 81.6%, respectively. Overall, 91.8% of patients met the threshold for achieving MCID in at least one outcome score. Of the 57 patients, 5 (8.8%) failed clinically, with 1 (1.8%) undergoing revision surgery and 4 (6.9%) undergoing conversion to total hip arthroplasty. There was a direct correlation between preoperative alpha angle and postoperative HOS-ADL. Femoral chondral lesion size and CMI inversely correlated with postoperative HOS-ADL. CONCLUSIONS: Treatment of hip chondral defects with microfracture and hyaline allograft augmentation demonstrated excellent survivorship and significantly improved patient report outcomes at 1 year. LEVEL OF EVIDENCE: IV, retrospective case series. CI - Copyright (c) 2022 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved. FAU - Luo, T David AU - Luo TD AD - Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, North Carolina, U.S.A. FAU - Beck, Edward C AU - Beck EC AD - Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, North Carolina, U.S.A. FAU - Trammell, Amy P AU - Trammell AP AD - Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, North Carolina, U.S.A. FAU - Koulopoulos, Michael W AU - Koulopoulos MW AD - Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, North Carolina, U.S.A. FAU - Edge, Carl C AU - Edge CC AD - Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, North Carolina, U.S.A. FAU - Marquez-Lara, Alejandro AU - Marquez-Lara A AD - Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, North Carolina, U.S.A. FAU - Al'Khafaji, Ian M AU - Al'Khafaji IM AD - Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, North Carolina, U.S.A. FAU - Schallmo, Michael S AU - Schallmo MS AD - Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, North Carolina, U.S.A. FAU - Stubbs, Allston J AU - Stubbs AJ AD - Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, North Carolina, U.S.A. Electronic address: stubbsaj@ncsportsmedicine.com. LA - eng PT - Journal Article DEP - 20220303 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. 2022 Oct;38(10):2827-2828. PMID: 36192044 MH - Activities of Daily Living MH - Allografts MH - Cartilage MH - *Cartilage Diseases/surgery MH - *Femoracetabular Impingement/surgery MH - *Fractures, Stress MH - Hip Joint/surgery MH - Humans MH - *Platelet-Rich Plasma MH - Retrospective Studies MH - Treatment Outcome EDAT- 2022/03/06 06:00 MHDA- 2022/10/06 06:00 CRDT- 2022/03/05 20:12 PHST- 2021/08/16 00:00 [received] PHST- 2022/02/18 00:00 [revised] PHST- 2022/02/20 00:00 [accepted] PHST- 2022/03/06 06:00 [pubmed] PHST- 2022/10/06 06:00 [medline] PHST- 2022/03/05 20:12 [entrez] AID - S0749-8063(22)00142-6 [pii] AID - 10.1016/j.arthro.2022.02.021 [doi] PST - ppublish SO - Arthroscopy. 2022 Oct;38(10):2819-2826.e1. doi: 10.1016/j.arthro.2022.02.021. Epub 2022 Mar 3.