Patients With Dysplasia Achieve Similar Outcomes and Survivorship As Non-Dysplastic Patients 10 Years Following Hip Arthroscopy for Femoroacetabular Impingement.
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引用次数: 0
Abstract
Purpose: To determine the long-term outcomes of hip arthroscopy (HA) for femoroacetabular impingement (FAI) in the presence of concomitant lateral rim dysplasia compared to a matched control group.
Methods: Patients undergoing HA between January 2009 and October 2013 with minimum 10-year follow up were reviewed. Inclusion criteria consisted of hip arthroscopy patients for FAI with evidence of lateral rim dysplasia (LCEA of <25o). Patients with lateral rim dysplasia, were matched to patients with a LCEA >30o, based on sex, Tonnis grade and age. Outcomes included survival (avoidance of total hip replacement {THR}), repeat-HA and patient-reported outcomes. Survivorship was assessed using a Kaplan-Meier curve and Log ranks test, while revision rates between groups were assessed using Chi Squared analysis. Between and within group analysis for PROs were conducted using Mann Whitney U and Wilcoxon signed ranks respectively. The proportion of cases achieving the patient acceptable symptom state (PASS) was compared between groups using Chi squared analysis.
Results: Forty-six dysplasia and 90 control cases were reported on. There was no statistical difference between groups for baseline metrics apart from the LCEA (p<0.001), Sharp angle (p<0.001) and Tonnis angle (p<0.001). By 10 years, 9% of dysplasia cases and 4% of control cases converted to THR. There was no statistical difference between groups for survival or revision rates. Both groups reported improvements in PROs and there was no difference between PRO scores at either timepoint. Excluding those undergoing THR, 84% and 83% of dysplasia and control cases respectively achieved PASS.
Conclusion: Hip arthroscopy for symptomatic femoroacetabular impingement (FAI) is a successful treatment in cases where dysplasia is present. Low complication rates, comparable outcomes to those without lateral rim dysplasia, and a high survivorship rate of 91% at minimum 10-year follow up are observed. Increasing Tonnis angle preoperatively may increase the risk of THR conversion.
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