AI Article Synopsis
- The study aimed to assess the effectiveness and patient recovery outcomes one year after patients underwent a specific hip treatment combining microfracture surgery with hyaline allograft and autologous platelet-rich plasma.
- A total of 57 patients were included in the analysis, showing significant improvements in various functional scores after the procedure while nearly 92% achieved a minimal clinically important difference (MCID) in at least one measure of recovery.
- Most patients reported enhanced hip functionality and quality of life post-surgery, with a small number (8.8%) facing clinical failure, indicating a generally positive outcome from the combined treatment approach for hip chondral defects.
Article Abstract
Purpose: To evaluate functional outcomes and survivorship in patients at 1 year after undergoing arthroscopic microfracture augmented with hyaline allograft for symptomatic chondral defects of the hip.
Methods: Consecutive patients with and without prior hip procedures presenting with Outerbridge grade IV chondral lesion of the acetabulum or femoral head were prospectively followed. Patients underwent hip microfracture augmented with hyaline allograft suspended in autologous platelet-rich plasma between October 2016 and April 2018. Extent of cartilage degeneration was quantified using the chondromalacia severity index (CMI). Patient functional scores, including Tegner, Hip Outcome Score-Activities of Daily Living (HOS-ADL), Sport-Specific Subscale (HOS-SSS), modified Harris Hip Score (mHHS), and Nonarthritic Hip Score (NAHS) were collected preoperatively and at minimum 1-year postoperatively. Minimal clinically important difference (MCID) was analyzed. Statistical significance was established at P < .05. Pearson's coefficient analysis was performed to identify preoperative variables correlated with clinical outcomes.
Results: Fifty-seven patients (86.4%) had minimum 1-year follow-up and were included in the final analysis, with a mean age and body mass index (BMI) of 38.3 ± 9.1 years and 27.7 ± 4.9 kg/m, respectively. Comparison of baseline and postoperative score averages demonstrated significant improvements in Tegner scores (3.7 ± 2.9 vs 5.1 ± 2.6; P = .003), HOS-ADL (63.3 ± 16.4 vs 89.1 ± 14.5; P < .001), HOS-SSS (40.8 ± 20.4 vs 79.5 ± 21.6; P < .001), mHHS (61.5 ± 16.2 vs 87.0 ± 17.7; P < .001), and NAHS (56.6 ± 14.9 vs 78.7 ± 18.3; P < .001). The percentage of patients who achieved MCID for HOS-ADL, HOS-SSS, mHHS, and NAHS were 89.8%, 83.0%, 75.6%, and 81.6%, respectively. Overall, 91.8% of patients met the threshold for achieving MCID in at least one outcome score. Of the 57 patients, 5 (8.8%) failed clinically, with 1 (1.8%) undergoing revision surgery and 4 (6.9%) undergoing conversion to total hip arthroplasty. There was a direct correlation between preoperative alpha angle and postoperative HOS-ADL. Femoral chondral lesion size and CMI inversely correlated with postoperative HOS-ADL.
Conclusions: Treatment of hip chondral defects with microfracture and hyaline allograft augmentation demonstrated excellent survivorship and significantly improved patient report outcomes at 1 year.
Level Of Evidence: IV, retrospective case series.
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| http://dx.doi.org/10.1016/j.arthro.2022.02.021 | DOI Listing |
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