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Joint Space Predicts THA After Hip Arthroscopy in Patients 50 Years and Older

  • Symposium: Advanced Hip Arthroscopy
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

All patients considering joint-preserving hip arthroscopy should be educated on the risk of THA after arthroscopy. The degree of radiographic osteoarthritis predicts subsequent THA. To provide patients with the best information, the best radiographic measure that predicts THA after hip arthroscopy should be identified.

Questions/purposes

We therefore determined if Tönnis grade, Kellgren-Lawrence grade, or joint space narrowing was superior in predicting THA after hip arthroscopy.

Methods

We retrospectively reviewed 203 patients 50 years of age or older treated with hip arthroscopy between March 2007 and October 2010. Of these, 96 patients met the study inclusion criteria. Sixty-five did not undergo THAs during the followup time (non-THA group) and 31 patients did (THA group). We determined Tönnis grade, Kellgren-Lawrence grade, and/or joint space narrowing before arthroscopy. The median followup for the non-THA group was 54 months (95% confidence interval, 49.9–58.9 months).

Results

In 81% of the patients, joint space accurately predicted THA or non-THA, whereas Kellgren-Lawrence was accurate in 73% and Tönnis grade was accurate in 65%. On binary logistic regression, the only predictor (r2 = 0.45) of THA was joint space of 2 mm or less.

Conclusions

Measuring joint space by determining if any measurement is 2 mm or less predicts patients progressing to THA after hip arthroscopy approximately 80% of the time. At this early time point, joint space measurements were the most accurate predictor of THA and should be used in patient education to define the risk of early failure from hip arthroscopy.

Level of Evidence

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

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Author information

Authors and Affiliations

  1. Center for Outcomes-Based Orthopaedic Research, The Steadman Philippon Research Institute, 181 W. Meadow Drive, Suite 100, Vail, CO, 81657, USA

    Marc J. Philippon MD, Karen K. Briggs MPH, John C. Carlisle MD & Diana C. Patterson BA

  2. Kansas City Bone and Joint, Overland Park, KS, USA

    John C. Carlisle MD

Authors
  1. Marc J. Philippon MD
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  2. Karen K. Briggs MPH
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  3. John C. Carlisle MD
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  4. Diana C. Patterson BA
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Corresponding author

Correspondence to Marc J. Philippon MD.

Additional information

The institution of one or more of the authors (MJP, KKB, JCC, DCP) has received, during the study period, funding from Smith & Nephew, Inc (Andover, MA, USA), Siemens Corp (Washington, DC, USA), Össur (Foothill Ranch, CA, USA), and Arthrex (Naples, FL, 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.

Clinical Orthopaedics and Related Research neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDA-approval status, of any drug or device prior to clinical use.

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 Steadman Philippon Research Institute, Vail, CO, USA.

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Philippon, M.J., Briggs, K.K., Carlisle, J.C. et al. Joint Space Predicts THA After Hip Arthroscopy in Patients 50 Years and Older. Clin Orthop Relat Res 471, 2492–2496 (2013). https://doi.org/10.1007/s11999-012-2779-4

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  • DOI: https://doi.org/10.1007/s11999-012-2779-4

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