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Arthroscopic Ligamentum Teres Reconstruction: Minimum 2-Year Patient-Reported Outcomes With Subanalysis of Patients With Ehlers-Danlos Syndrome.
Rosinsky, Philip J; Annin, Shawn; Maldonado, David R; Kyin, Cynthia; Meghpara, Mitchell B; Shapira, Jacob; Lall, Ajay C; Domb, Benjamin G.
Afiliación
  • Rosinsky PJ; American Hip Institute Research Foundation, Des Plaines, Illinois, U.S.A.
  • Annin S; American Hip Institute Research Foundation, Des Plaines, Illinois, U.S.A.
  • Maldonado DR; American Hip Institute Research Foundation, Des Plaines, Illinois, U.S.A.
  • Kyin C; American Hip Institute Research Foundation, Des Plaines, Illinois, U.S.A.
  • Meghpara MB; American Hip Institute Research Foundation, Des Plaines, Illinois, U.S.A.; AMITA Health St. Alexius Medical Center, Hoffman Estates, Illinois, U.S.A.
  • Shapira J; American Hip Institute Research Foundation, Des Plaines, Illinois, U.S.A.
  • Lall AC; American Hip Institute Research Foundation, Des Plaines, Illinois, U.S.A.; American Hip Institute, Des Plaines, Illinois, U.S.A.
  • Domb BG; American Hip Institute Research Foundation, Des Plaines, Illinois, U.S.A.; American Hip Institute, Des Plaines, Illinois, U.S.A.. Electronic address: DrDomb@americanhipinstitute.org.
Arthroscopy ; 36(8): 2170-2182, 2020 08.
Article en En | MEDLINE | ID: mdl-32360268
ABSTRACT

PURPOSE:

To report on minimum 2-year outcomes of patients undergoing arthroscopic ligamentum teres reconstruction (LTR).

METHODS:

Our institutional registry was retrospectively reviewed for all patients undergoing LTR between December 2012 and February 2016. LTR was indicated for a fully torn or dysfunctional ligamentum teres with symptomatic multidirectional instability not treatable by osteotomy or capsular plication alone. Demographic data, preoperative clinical and radiographic measures, and intraoperative data were recorded. Patient-reported outcome measures including the modified Harris Hip Score, the Non-Arthritic Hip Score, a visual analog scale score for pain, and patient satisfaction were recorded preoperatively and annually postoperatively. Revision arthroscopies and conversions to total hip arthroplasty were recorded.

RESULTS:

Twelve reconstruction procedures were performed in 10 patients during the study period. Minimum 2-year follow-up was available for 9 patients (11 hips). The mean follow-up time was 44.27 months (range, 24-72 months). There were 7 female and 2 male patients, and the mean age was 30.34 years (range, 17.23-43.68 years). Two hips underwent conversion to total hip arthroplasty at a mean of 21.12 months. For the remaining patients, significant improvements were observed in the modified Harris Hip Score (from 44.1 to 71.8), Non-Arthritic Hip Score (from 47.5 to 78.6), and visual analog scale score (from 7.8 to 3.6) (P < .05). The average patient satisfaction rating was 7.88 (range, 4-10). Subanalysis of 5 patients (7 hips) with a diagnosis of Ehlers-Danlos syndrome showed a higher failure rate in this group.

CONCLUSIONS:

Although LTRs are indicated and performed only in a select group of patients, the procedure can provide meaningful improvement in patient-reported outcomes, pain reduction, and patient satisfaction. However, most patients undergoing LTR at present have underlying factors that significantly mitigate their prognosis, such as Ehlers-Danlos syndrome or failed previous surgery. Because these patients represent a subset of patients with complex hip pathologies in whom treatment is difficult, the expectations of surgery should be set accordingly. LEVEL OF EVIDENCE Level IV, therapeutic study, case series.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Artroscopía / Síndrome de Ehlers-Danlos / Ligamentos Redondos / Medición de Resultados Informados por el Paciente / Articulación de la Cadera Tipo de estudio: Observational_studies / Prognostic_studies Límite: Adolescent / Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Arthroscopy Asunto de la revista: ORTOPEDIA Año: 2020 Tipo del documento: Article País de afiliación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Artroscopía / Síndrome de Ehlers-Danlos / Ligamentos Redondos / Medición de Resultados Informados por el Paciente / Articulación de la Cadera Tipo de estudio: Observational_studies / Prognostic_studies Límite: Adolescent / Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Arthroscopy Asunto de la revista: ORTOPEDIA Año: 2020 Tipo del documento: Article País de afiliación: Estados Unidos