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01.04.2015 | Symposium: 2014 Bernese Hip Symposium | Ausgabe 4/2015

Clinical Orthopaedics and Related Research® 4/2015

Does the Nature of Chondrolabral Injury Affect the Results of Open Surgery for Femoroacetabular Impingement?

Zeitschrift:
Clinical Orthopaedics and Related Research® > Ausgabe 4/2015
Autoren:
MD Christopher L. Peters, MD Lucas A. Anderson, MD Claudio Diaz-Ledezma, MS, ATC Mike B. Anderson, MD Javad Parvizi
Wichtige Hinweise
Each author certifies that he or she, or a member of his or her immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.
All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research ® editors and board members are on file with the publication and can be viewed on request.
Each author certifies that his or her institution approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.
This work was performed at the University of Utah School of Medicine, Salt Lake City, UT, USA; and the Rothman Institute at Thomas Jefferson University, Philadelphia, PA, USA.

Abstract

Background

The degree to which patient characteristics, clinical outcomes, and the nature, severity, and corresponding treatment of chondrolabral injury in femoroacetabular impingement (FAI) is associated with failure after surgery is incompletely understood.

Questions/purposes

(1) Are patient factors associated with failure (age, sex, body mass index, and preoperative modified Harris hip score [mHHS]) in the open surgical treatment of FAI? (2) Is the nature of chondrolabral injury associated with failure? (3) Are any specific chondrolabral injury treatment methods superior?

Methods

Between 2000 and 2008, 172 open surgical procedures in 167 patients were performed for the treatment of FAI by two surgeons at two separate academic medical centers. Ultimately, 142 patients were included in this retrospective study. Mean followup was 3 years (range, 1–12 years). Patient and clinical factors along with the nature, severity, and treatment of chondrolabral injuries were assessed for an association with failure, defined as conversion to THA or the inability to achieve the minimum clinically important difference of the mHHS. Thirty-two percent (45 of 142) of patients failed open surgical treatment of FAI.

Results

Patient factors associated with failure included age (odds ratio [OR], 1.04; p = 0.036) and preoperative mHHS (OR, 4.42; p = 0.033). Neither the nature of the labral lesion nor the severity of the chondral lesion demonstrated a relationship with failure (p > 0.05). Surgically, labral refixation was associated with a decrease in the risk of failure (OR, 0.31; p = 0.039).

Conclusions

We were unable to identify an increased risk of poor outcomes based on sex, body mass index, or severity of chondrolabral lesions. We did find an increased risk of poorer outcomes associated with age. Labral refixation was associated with a decrease in the risk of failure indicating that treatment methodology, rather than the nature of the chondrolabral injury, may be associated with clinical failure. Future studies will be needed to help determine optimal treatment strategies for chondrolabral injuries.

Level of Evidence

Level IV, therapeutic study.

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