Abstract
Chondral hip injuries are common secondary to femoroacetabular impingement (FAI). Treatment with arthroscopic procedures including chondroplasty and microfracture is becoming increasingly common but literature is limited to case series at specialist centres. The aim of this study is to compare outcomes of arthroscopic acetabular chondral procedures using the NAHR dataset (UK) which represents the largest series to date.
All adult Arthroscopies recorded in the NAHR from Jan 2012 were available for inclusion. Exclusions included significant arthritis and femoral, complex or revision chondral procedures. Patients completed iHOT-12 & EQ-5D Index pre-operatively, 6 and 12 months. Data was analysed using T-test/ANOVA for between group/within group for continuous variables, chi square test for categorical variables and linear regression model for multivariable analysis.
5,752 patients, 60% female. 27% Chondroplasty, 5% Microfracture, 68% no Chondral Procedure. Maximum acetabular Outerbridge classification 14% Grade 1, 15% Grade 2, 17% Grade 3, 8% Grade 4, 9% no damage, not recorded in 37%. Higher proportion of Cam impingement in association with chondral treatments and a larger proportion of patients with no impingement recorded in group with no chondral procedures. There was a significant improvement versus baseline for all groups in iHOT-12 and EQ-5D Index (p<0.0001) including Grade four Outerbridge. There was significantly greater improvement in pre-operative scores in the chondroplasty group compared to the microfracture group at 6 and 12 months (p<0.05).
Following hip arthroscopy, patients with chondral procedures experienced improved outcome scores despite Outerbridge 4 chondral damage. Presence of cam lesions are more commonly associated with chondral treatments. Good outcomes were maintained up to 12 months for chondral procedures, regardless of age or impingement pathology however pincers improved less and patients over 40 years took longer to see improvement.
