HIP International最新文献

{"title":"Conversion total hip arthroplasty following failed proximal femoral fixation: current concepts review.","authors":"Amaan Merchant, Elliot Onochie, Babar Kayani, James Donaldson, John G Stammers, John A Skinner","doi":"10.1177/11207000261415598","DOIUrl":"https://doi.org/10.1177/11207000261415598","url":null,"abstract":"<p><strong>Introduction: </strong>Failed internal fixation of proximal femoral fractures is associated with significant morbidity, mortality, and financial burden. Conversion total hip arthroplasty (THA) is a technically demanding salvage procedure associated with high risks of periprosthetic joint infection and instability.</p><p><strong>Methods: </strong>Independent searches of MEDLINE, EMBASE, and the Cochrane library were performed for studies published from 1990 onwards regarding conversion THA in adults following failed proximal femur fixation. Following screening, 34 studies were included in this review.</p><p><strong>Results: </strong>Predictors of failure include female sex, smoking, and tip-apex distance >25 mm. Preoperative screening for occult, extra-articular infection is vital, as pathogens often reside near hardware rather than within the joint. CT, ultrasound, and SPECT-CT are essential for assessing bone stock and identifying fluid collections. Dual-mobility cups effectively reduce dislocation rates to 0-3%. Functional scores improve significantly, though 10-year survivorship is approximately 86%.</p><p><strong>Discussion: </strong>Conversion THA provides substantial functional recovery but carries a 7-fold higher infection risk than primary THA. Success requires meticulous screening tailored to previous hardware sites and selecting femoral fixation based on bone quality and cortical defects. Specialised implants are essential for optimising long-term outcomes in this high-risk population.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000261415598"},"PeriodicalIF":1.1,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147364893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Direct superior approach versus posterior approach in patients with primary total hip arthroplasty: a systematic review and meta-analysis.","authors":"Mariany H Miyamoto, Marcos N Goularte, Ruan Pablo S Gomes, Giovana S Gaio, Gabriel Erzinger, Diego Lima","doi":"10.1177/11207000261422440","DOIUrl":"https://doi.org/10.1177/11207000261422440","url":null,"abstract":"<p><strong>Objectives: </strong>The benefits and risks of the minimally invasive direct superior approach (DSA) compared with the posterior approach (PA) in primary total hip arthroplasty (THA) remain uncertain.</p><p><strong>Methods: </strong>We performed a systematic review and meta-analysis comparing DSA and PA in primary THA. Outcomes included perioperative parameters, radiological and functional results, and postoperative complications. Statistical analysis was performed using Review Manager, with heterogeneity assessed using I². Subgroup analyses were restricted to randomised controlled trials (RCTs).</p><p><strong>Results: </strong>11 studies comprising 5217 patients were included, with 1259 undergoing DSA. DSA was associated with a shorter hospital stay (MD -0.67 days; <i>p</i> < 0.00001), reduced blood loss (MD -66.09 mL; <i>p</i> = 0.007), and increased Harris Hip Scores (HHS) within 3 months (MD 1.00; <i>p</i> = 0.03). No significant differences were observed in operating time, radiological outcomes, Oxford Hip Score, Western Ontario and McMaster Universities Osteoarthritis Score, 12-month HHS, or postoperative complications. Subgroup analysis revealed differences between RCTs and observational studies in length of stay (<i>p</i> < 0.0004), leg-length discrepancy (<i>p</i> = 0.07), and operating time (<i>p</i> = 0.04).</p><p><strong>Conclusions: </strong>DSA appears to be a safe, effective alternative to PA, providing less blood loss, shorter hospitalisation, and faster early recovery without compromising mid-term outcomes.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000261422440"},"PeriodicalIF":1.1,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147365017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An algorithm for automated femoral leg length and offset calculations on pelvis radiographs.","authors":"Kellen L Mulford, Ryan D Roman, Joshua R Labott, Elizabeth S Kaji, Austin F Grove, Michael J Taunton, Cody C Wyles","doi":"10.1177/11207000261421918","DOIUrl":"https://doi.org/10.1177/11207000261421918","url":null,"abstract":"<p><strong>Introduction: </strong>Manual measurement of leg length (LL) and offset can be tedious. This study developed an automated algorithm for measuring LL and offset from pre- and postoperative AP pelvis radiographs in a large cohort of THA patients.</p><p><strong>Methods: </strong>Using a deep learning model trained on 1100 total AP pelvis radiographs, an algorithm was developed to calculate LL and offset. Algorithm measurements were compared with manual measurements by 4 raters on a sample of 100 pre- and postoperative image pairs. Inter- and intra-rater consistency was calculated using the intraclass correlation coefficient (ICC). The algorithm was applied to calculate the pre- and postoperative LL and offset discrepancies and the change in LL and offset bilaterally in a cohort of 15,951 image pairs.</p><p><strong>Results: </strong>ICC values between the algorithm and human raters ranged from 0.83 to 0.88 for offset measurements and 0.92 to 0.97 for LL measurements. Human raters demonstrated good-to-excellent inter-rater ICC and uniformly excellent intra-rater ICC. Entire database measurements demonstrated shorter LLs for arthritic joints versus the contralateral leg preoperatively and reduced LL discrepancy post-arthroplasty.</p><p><strong>Conclusions: </strong>We present a deep learning algorithm for calculating LL and offset using AP pelvis radiographs. This tool can support population-level studies and may assist operative management.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000261421918"},"PeriodicalIF":1.1,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147364946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Histopathological characterization of the hip joint capsule: Comparative study of patients with hip osteoarthritis versus patients with femoral neck fracture.","authors":"Juan I Teves, Marcos R Latorre, Agustin Albani, Malena Mazza, Julieta Colatruglio, Pablo D Roitman, Martín A Buttaro, Pablo A Slullitel","doi":"10.1177/11207000261416040","DOIUrl":"https://doi.org/10.1177/11207000261416040","url":null,"abstract":"<p><strong>Introduction: </strong>We aimed to delineate the histological characteristics of the hip joint's capsule of patients undergoing hip arthroplasty (HA) for primary osteoarthritis (OA) versus femoral neck fracture (FNF).</p><p><strong>Methods: </strong>86 patients were included: 39 with OA and 47 with FNF. A 2×2 cm capsular sample was harvested near the transverse ligament. Sections (4 µm thick) were stained with haematoxylin and eosin. Outcomes included capsular thickness (mm), fibrosis percentage, vascularization grade, inflammatory infiltrate, and cartilaginous metaplasia.</p><p><strong>Results: </strong>Inflammatory infiltrates were present in 25.6% of OA cases and 12.8% of FNF (<i>p</i> = 0.127). Superficial degenerative changes were more common in OA (48.7%) than FNF (10.6%) (<i>p</i> < 0.01). Cartilaginous metaplasia was higher in OA (35.9%) versus FNF (6.4%) (<i>p</i> = 0.01). Vascular density showed no significant difference (<i>p</i> = 0.104). Severe fibrosis was more frequent in OA (46.2%) than FNF (8.5%) (<i>p</i> < 0.01). Mean capsular thickness was greater in OA (5 mm; IQR 4.3-7.1) than FNF (3.1 mm; IQR 2-4) (<i>p</i> < 0.01).</p><p><strong>Conclusions: </strong>The hip capsule in OA showed greater thickness, fibrosis, and cartilage metaplasia. These structural differences may influence joint stability and could partly explain differing postoperative outcomes between elective THA for OA and urgent THA for FNF.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000261416040"},"PeriodicalIF":1.1,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147364996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The concept of a universal safe zone is history: a retrospective cohort study of 1520 total hip arthroplasties.","authors":"Mikko Pulkkanen, Rasmus Liukkonen, Perttu Neuvonen, Antti Eskelinen, Aleksi Reito","doi":"10.1177/11207000261422569","DOIUrl":"https://doi.org/10.1177/11207000261422569","url":null,"abstract":"<p><strong>Introduction: </strong>Lewinnek safe zone has guided optimal acetabular cup positioning for decades. This study aimed to provide new data on dislocation rates after total hip arthroplasty (THA), assess the effects of cup positioning, and evaluate how well the event of dislocation can be predicted.</p><p><strong>Methods: </strong>A total of 1520 THAs performed at our hospital were included. The primary outcome was dislocation. Hips were divided into 20° × 20° areas with 5° intervals based on positioning, and crude dislocation rates were compared. Logistic regression models were used and the results reported using odds ratios with 95% confidence intervals. Predictive performances were assessed with R² and C-indexesResults:59 dislocations (48 posterior, 11 anterior) occurred, giving a dislocation rate of 3.9%. Neither a universal nor component-specific safe zone could be created. Cup brand was the most significant factor. Overall predicative values were 0.041-0.134 with R² values and 0.665-0.775 with C-index values.</p><p><strong>Conclusions: </strong>Dislocation after THA cannot be explained by cup positioning alone. Risk profiles differ between acetabular cup systems, and even though cup design emerged as a key factor, its explanatory power remained modest. These findings emphasize the multifactorial nature of dislocation and the limitations of universal safe zones.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000261422569"},"PeriodicalIF":1.1,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147365015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determining the incidence of abductor tears in total hip arthroplasty via direct lateral approach: a prospective analysis.","authors":"Elizabeth A Abe, Alec M Giakas, Matthew B Sherman, Gregory K Deirmengian, Eric B Smith, James J Purtill","doi":"10.1177/11207000261417954","DOIUrl":"https://doi.org/10.1177/11207000261417954","url":null,"abstract":"<p><strong>Introduction: </strong>Each surgical approach for primary THA has unique advantages. The direct lateral approach (DLA) offers increased visualisation of the gluteus medius and minimus tendons and, consequently, has been suggested to facilitate management of intraoperatively identified abductor tears. However, there remains a paucity of data exploring the frequency of abductor tears in patients undergoing primary THA via DLA. The purpose of this prospective study was to: (1) report the incidence of abductor tears in the DLA patients; and (2) identify risk factors for abductor tears in patients undergoing primary THA.</p><p><strong>Methods: </strong>All patients undergoing primary THA for osteoarthritis via the DLA by 3 high-volume, fellowship-trained arthroplasty surgeons from September 2023 to March 2024 were enrolled. Data on patient demographics and preoperative functional outcome scores were collected. The location, size, and tissue quality for patients with an abductor tear intraoperatively was also recorded. Receiver operating characters (ROC) curve analysis was utilised to determine abductor tear risk factors.</p><p><strong>Results: </strong>Of the 346 patients included in the analysis, 63 (18.2%) had an abductor tear. There was no difference in BMI, laterality, and preoperative functional outcome scores between groups. However, patients with an abductor tear were more likely to be older (70.1 ± 7.9 versus 65.0 ± 9.5 years, <i>p</i> < 0.001), Women (68.3% vs. 31.7%, <i>p</i> = 0.027), and have a higher age-adjusted Charlson comorbidity index score (4.0 ± 1.7 vs. 3.3 ± 1.9, <i>p</i> = 0.002). Using ROC curve analysis, patients 68 years of age or older were 2.99 times more likely to have a tear identified. Of all tears, 87.3% of tears were at the anterior aspect of the greater trochanter with a mean size of 26.6 ± 12.1 by 12.9 ± 11.5 mm.</p><p><strong>Conclusions: </strong>In the present study, the incidence of abductor tears in patients undergoing primary THA via the DLA was 18.2%. Future studies are needed to compare the implications of abductor tears encountered in primary THA.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000261417954"},"PeriodicalIF":1.1,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147365022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying patients at risk for short-term adverse events after hip arthroscopy: a machine learning analysis of a national database.","authors":"Samuel S Rudisill, Alexander L Hornung, Johnathon R McCormick, John T Streepy, Shane J Nho, Jorge Chahla","doi":"10.1177/11207000261420401","DOIUrl":"https://doi.org/10.1177/11207000261420401","url":null,"abstract":"<p><strong>Purpose: </strong>To develop and compare machine learning-based risk prediction models to identify patients at risk for short-term adverse outcomes (overnight admission, early complication, or readmission) after hip arthroscopy and to determine key predictive demographic and clinical factors.</p><p><strong>Methods: </strong>Data from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database were used to develop and compare risk prediction models aiming to: (1) identify patients likely to experience short-term adverse outcomes including overnight admission, early complication, or readmission; and (2) determine the most predictive demographic and clinical factors contributing to adverse outcomes following hip arthroscopy. Predictive models were developed using support vector machine, random forest, logistic regression, gradient boosting, and extreme gradient boosting methods.</p><p><strong>Results: </strong>A total of 1478 eligible patients were included (56.4% female, mean age 40.0 ± 14.9 years), of whom 214 (14.5%) experienced a short-term adverse event. Compared to patients with an uncomplicated outpatient surgical course, those experiencing a short-term adverse event exhibited higher rates of diabetes mellitus, hypertension requiring medication, COPD, bleeding disorder, wound class ⩾2, ASA class ⩾3, lower preoperative haematocrit, and longer operative times. Logistic regression produced the optimal model for predicting short-term adverse events (AUC = 0.763), with operative time, preoperative haematocrit, ASA class, surgical procedure (CPT code), and age identified as the strongest predictive features.</p><p><strong>Concusions: </strong>These findings demonstrate the value of ML and may assist in predicting surgical outcomes, guiding clinical decision-making, and managing patient expectations regarding their postoperative course.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000261420401"},"PeriodicalIF":1.1,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147364990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The influence of extra-articular changes on hip function in young adults with a history of Perthes disease.","authors":"Johan Olav Brevik, Kristine Risum, Armend Fejzulai, Terje Terjesen, Ola Wiig, Stefan Huhnstock","doi":"10.1177/11207000261420153","DOIUrl":"10.1177/11207000261420153","url":null,"abstract":"<p><strong>Background: </strong>Residual deformities after Perthes disease, such as high-rising greater trochanter (HGT) and reduced femoral offset (FO), may compromise abductor function and influence long-term hip function.</p><p><strong>Purpose: </strong>To determine the prevalence of HGT and abnormal FO in young adults with healed unilateral Perthes disease and evaluate their associations with the Stulberg classification and hip function.</p><p><strong>Methods: </strong>In this cross-sectional follow-up study, 180 individuals (mean age 28.2 years, 72% male) previously diagnosed with unilateral Perthes disease were examined with radiographs and clinical tests. Articulo-trochanteric distance (ATD) and FO were measured on calibrated pelvic radiographs. Femoral head shape was classified using a modified 3-group Stulberg classification. Hip function was evaluated using the Trendelenburg test, passive hip abduction range of motion, and the Copenhagen Hip and Groin Outcome Score (HAGOS).</p><p><strong>Results: </strong>ATD was significantly lower in Perthes hips compared to contralateral hips (7.7 mm [SD 9.6] vs. 20.7 mm [SD 6.2], <i>p</i> < 0.001). HGT was present in 70 individuals (39%), and a positive Trendelenburg test was observed in 12 Perthes hips (7%). Risk factors for a positive test included hip pain, aspherical femoral head, and surgical treatment. Mean FO was lower in Perthes hips (34.2 mm vs. 39.7 mm, <i>p</i> < 0.001), as was hip abduction (25.5° vs. 29.7°). ATD and FO were significantly associated with the modified Stulberg classification, particularly between Stulberg 1 and Stulberg 3 hips (<i>p</i> < 0.001). No significant associations were found between ATD, FO, and hip function parameters, nor between HGT and HAGOS scores in spherical hips.</p><p><strong>Conclusions: </strong>Reduced ATD and FO were prevalent in young adults with previous PD and were associated with the modified Stulberg classification but not with hip function.</p><p><strong>Clinical trials registration: </strong>ClinicalTrials.gov (NCT03995960).</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000261420153"},"PeriodicalIF":1.1,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147365057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimising stem selection for conversion total hip arthroplasty following femoral trochanteric fracture surgery: an exploratory study using thermoelastic stress analysis.","authors":"Koshiro Shimasaki, Ryunosuke Watanabe, Tomofumi Nishino, Tomohiro Yoshizawa, Fumi Hirose, Shota Yasunaga, Hajime Mishima, Yoshihisa Harada","doi":"10.1177/11207000251383048","DOIUrl":"10.1177/11207000251383048","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the effect of the stem length on femoral stress distribution, using thermoelastic stress analysis (TSA) to provide insights into optimal stem selection for conversion to total hip arthroplasty (cTHA) following femoral trochanteric fracture.</p><p><strong>Methods: </strong>6 simulated femurs were prepared via intramedullary nailing followed by implant removal to construct a post-explantation model. A screw hole was replicated 135 mm distal to the apex of the greater trochanter. Following femoral neck osteotomy, cTHA models were constructed using either a quadrangular taper collared standard or long stem. TSA was conducted under vertical loading, measuring the maximum change in the sum of principal stresses around the screw hole. The stress-reducing effects of both stems were compared using the Wilcoxon signed-rank test.</p><p><strong>Results: </strong>Maximum stress around the screw hole decreased after stem insertion, with a greater reduction in the long stem group. The median maximum stress at the distal screw hole measured 11.2 and 8.42 MPa laterally and -14.6 and -12.3 MPa medially for the standard and long stem, respectively. The long stem significantly reduced stress in both regions.</p><p><strong>Conclusions: </strong>Stem insertion alleviated stress concentration, with long stem offering greater relief. The long stem effectively redistributed stress, providing valuable insights for optimising stem selection and reducing postoperative fracture risk.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"259-268"},"PeriodicalIF":1.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145408803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defining the postoperative alpha angle threshold for improved outcomes in posterolateral cam lesions.","authors":"Mustafa Çeltik, Selahaddin Aydemir, Burak Duymaz, Ozgur Aydin, Onur Gursan, Mehmet Emin Arayıcı, Onur Hapa","doi":"10.1177/11207000251407084","DOIUrl":"10.1177/11207000251407084","url":null,"abstract":"<p><strong>Background: </strong>Femoroacetabular impingement syndrome (FAIS) is a common hip disorder that can lead to joint degeneration and osteoarthritis. Posterolateral (PL) cam lesions, characterised by an α angle >60° on anteroposterior (AP) pelvis and Dunn views, present significant surgical challenges due to their anatomical location and proximity to critical vascular structures. Effective surgical intervention relies on achieving optimal postoperative resection, yet clear radiographic thresholds for surgical success remain undefined.</p><p><strong>Objective: </strong>This study aimed to investigate the relationship between postoperative α angle measurements on pelvis AP radiographs and clinical outcomes in patients undergoing hip arthroscopy for PL cam lesions. Additionally, it seeks to determine an optimal postoperative α angle threshold that correlates with improved patient-reported outcomes at 2 years.</p><p><strong>Methods: </strong>A retrospective analysis was performed on a cohort of 117 patients (121 hips) who underwent hip arthroscopy for femoroacetabular impingement syndrome (FAIS) between the years 2013 and 2022, with a minimum follow-up period of 2 years. Preoperative and postoperative α angles were measured on the pelvis AP and Dunn views. Clinical outcomes were assessed using the Hip Outcome Score-Activities of Daily Living (HOS-ADL), the modified Harris Hip Score (mHHS), and the Non-Arthritic Hip Score (NAHS). Receiver operating characteristic (ROC) curve analysis was used to establish an α angle cutoff associated with better functional recovery.</p><p><strong>Results: </strong>Patients with a postoperative α angle below 55° demonstrated significantly better functional outcomes across all scoring systems. ROC analysis confirmed that α < 55° was a strong predictor of achieving a patient-acceptable symptomatic state (PASS), with an area under the curve (AUC) of 0.849 for mHHS, 0.741 for NAHS, and 0.721 for HOS-ADL (<i>p</i> < 0.001). Sensitivity and specificity values varied across scoring systems, with PASS-NAHS showing a sensitivity of 88.0% and specificity of 52.6%, PASS-HOS-ADL demonstrating a sensitivity of 88.0% and specificity of 52.6%, and PASS-mHHS revealing a sensitivity of 87.6% and specificity of 75%. Multivariate logistic regression further confirmed that a postoperative α angle below 55° was independently associated with improved hip function, reinforcing its significance as a key threshold for surgical success.</p><p><strong>Conclusion: </strong>A postoperative pelvis AP α angle of less than 55° appears to be a key threshold for optimal recovery in patients with PL cam lesions. These findings highlight the importance of adequate resection during hip arthroscopy to enhance functional outcomes. Further research with larger patient cohorts and advanced imaging techniques may help refine postoperative evaluation criteria.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"295-302"},"PeriodicalIF":1.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13050996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147283476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}