View ePoster

LOYOLA
UNIVERSITY CHICAGO
Which demographic factors influence
outcomes following hip arthroscopy for
femoroacetabular impingement?
Benjamin G Domb, M.D.
Christine E. Stake, D.H.A.
John M. Redmond, M.D.
Nathan A. Finch, M.A.
Kevin F. Dunne, B.S.
Chengcheng Gui, B.S.
Brian Dierckman, M.D.
AmericanHinsdale
Hip Institute and Hinsdale
Orthopaedics
LOYOLA
Orthopaedics
Westmont, IL
UNIVERSITY CHICAGO
Disclosures – Dr. Benjamin Domb
• American Hip Institute • Stock:
Research support:
o Stryker
o American Hip Institute
• Royalties:
o
o
o
o
o
Arthrex, Inc.
Mako Surgical Corp.
Breg
ATI
Pacira
• Consulting:
o Arthrex, Inc.
o Orthomerica
o DJO Global
• AANA Learning Center
Committee
o Arthrex, Inc.
o Mako Surgical Corp.
o Pacira
Hinsdale
Orthopaedics
LOYOLA
UNIVERSITY CHICAGO
2
Background
• Femoroacetabular impingement
(FAI) can lead to pain, labral tears,
advancement of osteoarthritis
• Two main types:
o Pincer: overcoverage of socket
o Cam: non-spherical head
Hinsdale
Orthopaedics
LOYOLA
UNIVERSITY CHICAGO
3
Background
• Hip arthroscopy is preferred
surgical treatment for common
pathology in patients with FAI
• Limited research on demographic
factors influencing patientreported outcome (PRO) scores
after hip arthroscopy for FAI
Hinsdale
Orthopaedics
LOYOLA
UNIVERSITY CHICAGO
4
Methods and Selection of Patient Cohort
• Identified all patients in our database who underwent
primary hip arthroscopy for treatment of FAI over 4 year
period with minimum of 2-year follow-up
• 868 consecutive patients identified; 728 had minimum 2year follow-up (84%), and 59 (8%) underwent THA
• Excluded workers’ compensation cases, borderline/mild
dysplasia cases, revision surgeries
• Measured VAS pain score and four PRO scores (mHHS,
NAHS, HOS-ADL, HOS-SSS) preoperatively and at two years
postoperatively; also measured patient satisfaction at twoyear postoperatively
Hinsdale
Orthopaedics
LOYOLA
UNIVERSITY CHICAGO
5
Summary of Results – Age
• Mean 36, range 13-76:
• Older patients had
lower pre- and
postoperative scores
• Level of improvement
not significantly
correlated with age
Hinsdale
Orthopaedics
LOYOLA
UNIVERSITY CHICAGO
6
Summary of Results – BMI
• Mean 25.0, range 16.3 43.6
• Higher BMI correlated
with lower pre- and
postoperative scores
• Level of improvement not
significantly correlated
with BMI
Hinsdale
Orthopaedics
LOYOLA
UNIVERSITY CHICAGO
7
Summary of Results – Acute Injury
• Similar improvement
in patients with or
without acute injury
in all measures
except HOS-SSS
• Patients with acute
injuries improved
27% more in HOS-SSS
Hinsdale
Orthopaedics
LOYOLA
UNIVERSITY CHICAGO
8
Duration of Symptoms
• Duration of symptoms not
correlated with preoperative
scores
• Patients with longer duration of
symptoms had lower
postoperative PRO scores,
poorer satisfaction, and higher
pain scores
• However, level of improvement
not correlated not correlated
with duration of symptoms
Hinsdale
Orthopaedics
LOYOLA
UNIVERSITY CHICAGO
9
Summary of Results – Gender
• 67% female
• Females had lower preoperative
PROs, but no differences in
postoperative PROs
• Women had slightly higher
improvements in mHHS, NAHS,
and VAS
• Males had slightly higher
improvements in HOS-ADL and
HOS SSS
Hinsdale
Orthopaedics
LOYOLA
UNIVERSITY CHICAGO
10
Conclusions
• Age, BMI, acute injury, gender, and
duration of symptoms are correlated
with either postoperative scores or
improvement in scores
• Based on patient satisfaction, VAS,
mHHS, NAHS, HOS-ADL, and HOS-SSS
Hinsdale
Orthopaedics
LOYOLA
UNIVERSITY CHICAGO
11
Selected References
•
Lodhia P, Slobogean GP, Noonan VK, Gilbert MK. Patient-reported outcome instruments for
femoroacetabular impingment and hip labral pathology: A systematic review of the clinimetric
evidence. Arthroscopy 2011;27:279-286.
•
Byrd JWT, Jones KS. Arthroscopic management of femoroacetabular impingement: minimum 2-year
follow-up. Arthroscopy 2011;27:1379-1388.
•
Domb BG, Stake CE, Botser IB, Jackson TJ. Surgical dislocation of the hip versus arthroscopic
treatment of femoroacetabular impingement: A prospective matched-pair study with average 2-year
follow-up. Arthroscopy 2013;29:1506-1513.
•
Jackson TJ, Stake CE, Trenga AP, Morgan J, Domb BG. Arthroscopic technique for treatment of
femoroacetabular impingement. Arthroscopy Techniques 2014;2.1:55-59.
•
Philippon MJ, Briggs KK, Yen YM, Kuppersmith DA. Outcomes following hip arthroscopy for
femoroacetabular impingement with associated chondrolabral dysfunction – minimum two-year
follow-up. Journal of Bone & Joint Surgery, British Volume 2009;91.1:16-23.
Hinsdale
Orthopaedics
LOYOLA
UNIVERSITY CHICAGO
12