Minimum 2-Year Outcomes of Arthroscopic Management of Symptomatic Hip Labrum Tears in Patients With Global Acetabular Overcoverage.
Arthroscopy
; 33(8): 1514-1520, 2017 Aug.
Article
en En
| MEDLINE
| ID: mdl-28412060
ABSTRACT
PURPOSE:
To report minimum 2-year patient-reported outcomes (PROs) after hip arthroscopy (HA) for symptomatic labral tears in patients with global acetabular overcoverage.METHODS:
This study was a retrospective case series of patients who underwent HA from April 2008 to April 2013. The inclusion criteria were patients with global acetabular overcoverage, defined as a lateral center-edge angle greater than 40°, and with coxa profunda, defined radiologically by the ilioischial line lateral to the acetabular floor. Only patients with minimum 2-year follow-up and no history of hip conditions or surgery were included. We recorded demographic, examination, radiologic, and intraoperative findings; intraoperative procedures performed; and the following PROs modified Harris Hip Score (mHHS), Non-Arthritic Hip Score, Hip Outcome Score-Activities of Daily Living (HOS-ADL), Hip Outcome Score-Sports-Specific Subscale (HOS-SSS), visual analog scale, and patient satisfaction.RESULTS:
The inclusion criteria were met by 39 patients, of whom 35 (89.7%) had 2-year follow-up. There was no distinct pattern of examination findings. The study population had a mean acetabular inclination of -1.19° and an anterior center-edge angle of 35°. There was no association with measures of acetabular retroversion. Intrasubstance tearing of the labrum occurred in 75% of patients (mean tear size, 2.68 hours on acetabular clock face; mean location, 11.5 to 3 on acetabular clock face). There were significant improvements in the mean scores for all PROs mHHS, 13.5 ± 17.7 points (P < .01); Non-Arthritic Hip Score, 14.3 ± 21.3 (P < .001); HOS-ADL, 11.6 ± 19.7 (P < .001); HOS-SSS, 17.1 ± 35.1 (P < .001); and visual analog scale, -2.77 ± 2.58 (P < .001). The mean patient satisfaction rating was 6.61. The improvements in mHHS, HOS-ADL, and HOS-SSS did not reach the minimal clinically important difference. The incidence of secondary procedures was 17% (4 patients underwent conversion to total hip arthroplasty and 2 required revision HA).CONCLUSIONS:
HA in patients with global acetabular overcoverage was associated with improvements in PROs and pain at minimum 2-year follow-up. However, these improvements did not reach the minimal clinically important difference for the mHHS, HOS-ADL, and HOS-SSS. The incidence of secondary procedures was 17%. The pattern of labral injury is predominantly intrasubstance labral damage with a narrow rim of adjacent chondral injury. LEVEL OF EVIDENCE Level IV, therapeutic case series.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Cabeza Femoral
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Pinzamiento Femoroacetabular
Tipo de estudio:
Diagnostic_studies
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Observational_studies
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Risk_factors_studies
Límite:
Adolescent
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Adult
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Arthroscopy
Asunto de la revista:
ORTOPEDIA
Año:
2017
Tipo del documento:
Article
País de afiliación:
Estados Unidos