PMID- 36688631
OWN - NLM
STAT- MEDLINE
DCOM- 20230302
LR  - 20230303
IS  - 1552-3365 (Electronic)
IS  - 0363-5465 (Linking)
VI  - 51
IP  - 3
DP  - 2023 Mar
TI  - High Survivorship and Comparable Patient-Reported Outcomes at a Minimum 5 Years 
      After Hip Arthroscopic Surgery in Patients With Femoroacetabular Impingement, 
      With and Without Lateral Rim Dysplasia.
PG  - 678-686
LID - 10.1177/03635465221145018 [doi]
AB  - BACKGROUND: Femoroacetabular impingement (FAI) in patients with dysplasia 
      presents a unique challenge to surgeons. Short-term outcomes are conflicting, 
      while longer term follow-up data are only emerging. PURPOSE: To quantify midterm 
      (minimum 5-year follow-up) outcomes after the arthroscopic correction of FAI in 
      the presence of lateral rim dysplasia compared with a matched control group with 
      FAI with normal acetabular coverage. STUDY DESIGN: Cohort study; Level of 
      evidence, 3. METHODS: Prospective outcome data, collected in a consecutive series 
      of patients undergoing arthroscopic FAI correction with lateral rim dysplasia 
      (lateral center-edge angle [LCEA] of 13 degrees -25 degrees ), were reviewed (N = 75 cases). An 
      age- and sex-matched control group of 120 cases was also formed (LCEA >25 degrees ). 
      Survivorship was defined as the avoidance of total hip replacement and assessed 
      using a Kaplan-Meier curve with the log-rank test. Survival rates and 
      patient-reported outcome measure (PROM) scores (modified Harris Hip Score [mHHS], 
      University of California, Los Angeles [UCLA], 36-Item Short Form Health Survey 
      [SF-36], and Western Ontario and McMaster Universities Osteoarthritis Index 
      [WOMAC] preoperatively and at 5 years postoperatively) were compared between the 
      groups. The proportion of patients across groups achieving the minimal clinically 
      important difference (MCID) was compared for each PROM. The dysplasia group was 
      also analyzed independently to identify any factors that may indicate a less 
      favorable outcome using regression analysis. The group was divided into 2 
      subgroups: borderline dysplasia (LCEA of 20 degrees -25 degrees ) and severe dysplasia (LCEA 
      <20 degrees ). RESULTS: The survival rate in the dysplasia group was 97%. There was no 
      statistical difference with respect to survival rates or any PROM scores (P > .05 
      for all) between the groups. There were similar rates of achieving the MCID 
      between the groups for the mHHS, UCLA, and WOMAC. The FAI control group had a 
      higher rate of achieving the MCID for the SF-36 (P = .012; effect size = 0.274 
      [small]). Subgroup analysis indicated a lower survival rate (78% vs 100%, 
      respectively; P < .001) in female cases in the dysplasia group (n = 9) compared 
      with male cases in the dysplasia group (n = 66). The UCLA score in female cases 
      in the dysplasia group at 5 years was statistically lower compared with that in 
      male cases in the dysplasia group (6 vs 10, respectively; P = .003; effect size = 
      0.378 [medium]), but no other outcome revealed any differences between the sexes. 
      There were also no variables identified on regression analysis that accurately 
      predicted a poorer outcome in the dysplasia group. When stratified by severity, 
      there was no difference in survivorship or outcomes between those with severe 
      dysplasia (LCEA <20 degrees ; n = 11) and those with borderline dysplasia (LCEA of 
      20 degrees -25 degrees ; n = 64). CONCLUSION: An arthroscopic intervention was a successful 
      treatment option for FAI in the presence of lateral rim dysplasia at midterm 
      follow-up. Irrespective of the severity of dysplasia, patients can expect similar 
      improvements to those in patients with normal femoral head coverage.
FAU - Mullins, Karen
AU  - Mullins K
AD  - UPMC Sports Medicine Clinic, Carriganore, Ireland.
FAU - Filan, David
AU  - Filan D
AD  - UPMC Sports Medicine Clinic, Carriganore, Ireland.
FAU - Carton, Patrick
AU  - Carton P
AD  - UPMC Sports Medicine Clinic, Carriganore, Ireland.
AD  - The Hip and Groin Clinic, Waterford, Ireland.
LA  - eng
PT  - Journal Article
DEP - 20230123
PL  - United States
TA  - Am J Sports Med
JT  - The American journal of sports medicine
JID - 7609541
SB  - IM
MH  - Humans
MH  - Male
MH  - Female
MH  - *Femoracetabular Impingement/surgery
MH  - Hip Joint/surgery
MH  - Cohort Studies
MH  - Prospective Studies
MH  - *Hip Dislocation/surgery
MH  - Survivorship
MH  - Arthroscopy/methods
MH  - Treatment Outcome
MH  - Patient Reported Outcome Measures
MH  - Retrospective Studies
MH  - Follow-Up Studies
OTO - NOTNLM
OT  - FAI
OT  - arthroscopic surgery
OT  - dysplasia
OT  - impingement
OT  - labral repair
OT  - lateral rim
EDAT- 2023/01/24 06:00
MHDA- 2023/03/03 06:00
CRDT- 2023/01/23 08:53
PHST- 2023/01/24 06:00 [pubmed]
PHST- 2023/03/03 06:00 [medline]
PHST- 2023/01/23 08:53 [entrez]
AID - 10.1177/03635465221145018 [doi]
PST - ppublish
SO  - Am J Sports Med. 2023 Mar;51(3):678-686. doi: 10.1177/03635465221145018. Epub 
      2023 Jan 23.