PMID- 38061686
OWN - NLM
STAT- Publisher
LR  - 20231230
IS  - 1526-3231 (Electronic)
IS  - 0749-8063 (Linking)
DP  - 2023 Dec 5
TI  - Decreased Hip Labral Width Measured on Preoperative Magnetic Resonance Imaging Is 
      Associated With Greater Revision Rate After Primary Arthroscopic Labral Repair 
      for Femoroacetabular Impingement Syndrome at 5-Year Follow-Up.
LID - S0749-8063(23)00959-3 [pii]
LID - 10.1016/j.arthro.2023.11.030 [doi]
AB  - PURPOSE: To examine the associations between hip labral width and 
      patient-reported outcomes, clinical threshold achievement rates, and rate of 
      reoperation among patients with femoroacetabular impingement syndrome (FAIS) who 
      underwent hip arthroscopy and labral repair at minimum 5-year follow-up. METHODS: 
      Patients were identified from a prospective database who underwent primary hip 
      arthroscopy for treatment of labral tears and FAIS. Modified Harris Hip Score 
      (mHHS) and Nonarthritic Hip Score (NAHS) were recorded preoperatively and at 
      5-year follow-up. Achievement of the minimal clinically important difference 
      (MCID), substantial clinical benefit (SCB), and patient-acceptable symptom state 
      (PASS) was determined using previously established values. Labral width magnetic 
      resonance imaging measurements were performed by 2 independent readers at 
      standardized "clockface" locations. Patients were stratified into 3 groups at 
      each position: lower-width (<(1/2) SD below mean), middle-width (within (1/2) SD of 
      mean), and upper-width (>(1/2) SD above mean). Multivariable regression was used to 
      evaluate associations of labral width with patient-reported outcomes and 
      reoperation rate. RESULTS: Seventy-three patients (age: 41.0 +/- 12.0 years; 68.5% 
      female) were included. Inter-rater reliability for labral width measurements was 
      high at all positions (intraclass correlation coefficient 0.94-0.96). There were 
      no significant intergroup differences in mHHS/NAHS improvement (P > .05) or in 
      achievement rates of MCID/SCB/PASS at each clockface position (P > .05). Eleven 
      patients (15.1%) underwent arthroscopic revision and 4 patients (5.5%) converted 
      to total hip arthroplasty. Multivariable analysis found lower-width groups at 
      11:30 (odds ratio 1.75, P = .02) and 3:00 (odds ratio 1.59, P = .04) positions to 
      have increased odds of revision within 5 years; however, labral width was not 
      associated with 5-year improvement in mHHS/NAHS, achievement of MCID/PASS/SCB, or 
      conversion to total hip arthroplasty (P > .05). CONCLUSIONS: Hip labral width <(1/2) 
      SD below the mean measured on preoperative magnetic resonance imaging at 11:30- 
      and 3:00-clockface positions was associated with increased odds of reoperation 
      after arthroscopic labral repair and treatment of FAIS. Labral width was not 
      associated with 5-year improvement of mHHS, NAHS, achievement of clinical 
      thresholds, or conversion to arthroplasty. LEVEL OF EVIDENCE: Level IV, case 
      series.
CI  - Copyright (c) 2023 Arthroscopy Association of North America. Published by Elsevier 
      Inc. All rights reserved.
FAU - Li, Zachary I
AU  - Li ZI
AD  - Department of Orthopedic Surgery, New York University Langone Health, New York, 
      New York, U.S.A.
FAU - Shankar, Dhruv S
AU  - Shankar DS
AD  - Department of Orthopedic Surgery, New York University Langone Health, New York, 
      New York, U.S.A.
FAU - Vasavada, Kinjal D
AU  - Vasavada KD
AD  - Department of Orthopedic Surgery, New York University Langone Health, New York, 
      New York, U.S.A.
FAU - Akpinar, Berkcan
AU  - Akpinar B
AD  - Department of Orthopedic Surgery, New York University Langone Health, New York, 
      New York, U.S.A.
FAU - Lin, Lawrence J
AU  - Lin LJ
AD  - Department of Orthopedic Surgery, New York University Langone Health, New York, 
      New York, U.S.A.
FAU - Samim, Mohammad M
AU  - Samim MM
AD  - Department of Radiology, New York University Langone Health, New York, New York, 
      U.S.A.
FAU - Burke, Christopher J
AU  - Burke CJ
AD  - Department of Radiology, New York University Langone Health, New York, New York, 
      U.S.A.
FAU - Youm, Thomas
AU  - Youm T
AD  - Department of Orthopedic Surgery, New York University Langone Health, New York, 
      New York, U.S.A.. Electronic address: Thomas.youm@nyulangone.org.
LA  - eng
PT  - Journal Article
DEP - 20231205
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
COIS- Disclosure The authors report the following potential conflicts of interest or 
      sources of funding: C.J.B. reports personal fees from BD Biosciences, outside the 
      submitted work. T.Y. reports personal fees from Arthrex, outside the submitted 
      work. All other authors (Z.I.L., D.S.S., K.D.V., B.A., L.J.L., M.M.S.) declare 
      that they have no known competing financial interests or personal relationships 
      that could have appeared to influence the work reported in this paper. Full ICMJE 
      author disclosure forms are available for this article online, as supplementary 
      material.
EDAT- 2023/12/08 00:42
MHDA- 2023/12/08 00:42
CRDT- 2023/12/07 19:29
PHST- 2023/06/10 00:00 [received]
PHST- 2023/11/07 00:00 [revised]
PHST- 2023/11/19 00:00 [accepted]
PHST- 2023/12/08 00:42 [pubmed]
PHST- 2023/12/08 00:42 [medline]
PHST- 2023/12/07 19:29 [entrez]
AID - S0749-8063(23)00959-3 [pii]
AID - 10.1016/j.arthro.2023.11.030 [doi]
PST - aheadofprint
SO  - Arthroscopy. 2023 Dec 5:S0749-8063(23)00959-3. doi: 10.1016/j.arthro.2023.11.030.