Inferior Outcomes Reported for High-Grade Hip Cartilage Damage

Patients undergoing hip arthroscopy with high-grade cartilage damage do not see as positive results compared with patients with lower grade cartilage damage, according to research reported at the American Orthopedic Society of Sports Medicine-Arthroscopy Association of North America Combined 2021 Annual Meeting.
 
The research was presented by Dominic Carreira, M.D., of Peachtree Orthopedics in Atlanta. Dr. Carreira and his colleagues sought to determine what the impact of acetabular cartilage damage on outcomes following primary repair of acetabular labral tears.
 
When articular cartilage is damaged, joint pain may result. If the articular cartilage damage becomes diffuse, the term arthritis is used.
 
To determine this, researchers queried a multi-center hip arthroscopy registry for patients undergoing primary labrum repair from 2014-2017 with documented two-year outcomes. They assigned 472 patients to one of three groups according to severity of articular cartilage damage in the Beck classification system: None, Low Grade (Grade 1 or 2), or High Grade (Grade 3 or 4) Damage.
 
Patients in all three groups experienced statistically significant improvement in iHOT-12 scores from baseline to final follow-up (p<0.001). The iHOT-12 scores at two years were significantly higher in patients with no acetabular articular cartilage damage (mean± SD, 80 ± 21)relative to patients with high grade damage (71 ± 25) (Dunn test, p<0.001).
 
When accounting for age, BMI, gender, and preoperative iHOT12 scores in logistic regression models for clinically significant outcome thresholds, presence of high grade lesions was a negative predictor for achieving the MCID (odds ratio [95 percent CI], 0.49 [0.25, 0.91]) and the PASS (0.61 [0.38, 0.98]). Among patients with high grade lesions, there was no significant difference in two-year iHOT-12 scores between those undergoing chondroplasty (N = 57) and those undergoing microfracture (N =19) (p =0.13).
 
“High grade acetabular articular damage portends inferior patient-reported outcomes two years after primary labral repair,” Carreira reported. “And our results suggest no difference between the efficacy of chondroplasty and microfracture with respect to self-reported outcomes.”
 
The American Orthopaedic Society for Sports Medicine (AOSSM) is the premier global, sports medicine organization representing the interests of orthopaedic surgeons and other professionals who provide comprehensive health services for the care of athletes and active people of all ages and levels. The organization cultivates evidence-based knowledge, provide extensive educational programming, and promote emerging research that advances the science and practice of sports medicine. AOSSM is also a founding partner of the STOP Sports Injuries campaign to prevent overuse and traumatic injuries in kids.