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Intraoperative Cartilage Degeneration Predicts Outcome 12 Months After Hip Arthroscopy

Abstract

Background

When considering arthroscopic surgery for treatment of hip pain, it is important to understand the influence of joint degeneration on the likelihood of success. Previous research has shown poorer outcomes among patients with osteoarthritis but new arthroscopic techniques including femoroacetabular impingement correction and microfracture may lead to better arthroscopic outcomes.

Questions/Purposes

We investigated the effect of intraarthroscopic articular and rim cartilage degeneration on the outcome after hip arthroscopy using contemporary techniques.

Methods

The modified Harris hip score (MHHS) and nonarthritic hip score (NAHS) were completed preoperatively and 12 months postoperatively by 560 patients undergoing hip arthroscopy after March 2007. Change in these scores was compared between patients with and without acetabular or femoral articular cartilage degeneration and between patients with and without rim cartilage degeneration. Correlation and regression analyses were used to predict the change in outcome scores based on the severity of cartilage degeneration.

Results

Hips without degeneration had greater improvement in the outcome scores. The presence of cartilage degeneration showed negative correlations with change in outcomes. The best model to explain change in MHHS included preoperative score, articular cartilage degeneration grade, and rim lesion grade (adjusted R2 = 0.24).

Conclusions

Our data support previous findings regarding the negative influence of cartilage degeneration on improvement after hip arthroscopy. Nevertheless, many patients with cartilage degeneration still improved and the severity of degeneration accounts for little of the resulting variance in change. Future studies must determine the clinical importance of the improvements gained by patients with cartilage degeneration and identify other predictors of outcome.

Level of Evidence

Level III, prognostic study. See Instructions for Authors for a complete description of levels of evidence.

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Acknowledgments

We thank Jess O’Donnell BA, BComm, for assisting with extraction of data from the database for this study.

Author information

Correspondence to Thorlene Egerton PhD.

Additional information

One of the authors (JO) certifies that he has or may receive payments or benefits, during the study period, an amount of $10,000 to $100,000, from Smith & Nephew Inc (Memphis, TN, USA).

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, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

This work was performed at The University of Melbourne, Carlton, VIC, Australia.

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Egerton, T., Hinman, R.S., Takla, A. et al. Intraoperative Cartilage Degeneration Predicts Outcome 12 Months After Hip Arthroscopy. Clin Orthop Relat Res 471, 593–599 (2013). https://doi.org/10.1007/s11999-012-2594-y

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Keywords

  • Articular Cartilage
  • NAHS
  • Cartilage Degeneration
  • Preoperative Score
  • Labral Repair