We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Treatment of Full-Thickness Acetabular Chondral Flaps During Hip Arthroscopy: Bone Marrow Aspirate Concentrate Versus Microfracture.
- Authors
Kucharik, Michael P.; Abraham, Paul F.; Nazal, Mark R.; Varady, Nathan H.; Eberlin, Christopher T.; Meek, Wendy M.; Naessig, Sara A.; Martin, Scott D.
- Abstract
Background: The optimal treatment strategy for patients with full-thickness chondral flaps undergoing hip arthroscopy is controversial. Purpose: To compare functional outcomes of patients who underwent bone marrow aspirate concentrate (BMAC) application with those of patients who underwent microfracture. Study Design: Cohort study; Level of evidence, 3. Methods: This was a retrospective case series of prospectively collected data on patients who underwent arthroscopic acetabular labral repair by 1 surgeon between June 2014 and April 2020. The inclusion criteria for this study were age ≥18 years, preoperative radiographs of the pelvis, arthroscopic acetabular labral repair, exposed subchondral bone with overlying chondral flap seen at the time of hip arthroscopy, microfracture or BMAC to address this lesion, and completed patient-reported outcome measures (PROMs) (International Hip Outcome Tool–33 [iHOT-33], Hip Outcome Score–Activities of Daily Living [HOS-ADL], Hip Outcome Score–Sports Subscale [HOS-Sport], modified Harris Hip Score [mHHS], and visual analog scale [VAS] for pain) at enrollment and 12-month follow-up. Clinical outcomes were assessed using PROM scores. Results: A total of 81 hips with full-thickness chondral flaps were included in this study: 50 treated with BMAC and 31 treated with microfracture. There were no significant differences between groups in age, sex, body mass index, tear size, radiographic osteoarthritis, or radiographic femoroacetabular impingement. In the BMAC cohort, all PROM scores improved significantly from preoperatively to follow-up: 41.7 to 75.6 for iHOT-33, 67.6 to 91.0 for HOS-ADL, 41.5 to 72.3 for HOS-Sport, 59.4 to 87.2 for mHHS, and 6.2 to 2.2 for VAS pain (P <.001 for all). In the microfracture cohort, the score improvements were 48.0 to 65.1 for iHOT-33 (P =.001), 80.5 to 83.3 for HOS-ADL (P =.275), 59.2 to 62.4 for HOS-Sport (P =.568), 70.4 to 78.3 for mHHS (P =.028), and 4.9 to 3.6 for VAS pain (P =.036). Regarding clinically meaningful outcomes, 77.6% of the BMAC group and 50.0% of the microfracture group met the minimal clinically important difference for iHOT-33 at the 12-month follow-up (P =.013). Conclusion: Patients with full-thickness chondral flaps at the time of hip arthroscopy experienced greater improvements in functional outcome scores at the 12-month follow-up when treated with BMAC as opposed to microfracture.
- Subjects
MASSACHUSETTS; HIP surgery; BONE marrow transplantation; ACQUISITION of data methodology; ARTHROSCOPY; ARTHROPLASTY; SURGERY; PATIENTS; RETROSPECTIVE studies; VISUAL analog scale; FISHER exact test; FUNCTIONAL assessment; TREATMENT effectiveness; T-test (Statistics); HIP joint injuries; RESEARCH funding; MEDICAL records; CASE studies; DESCRIPTIVE statistics; CHI-squared test; ARTICULAR cartilage; DATA analysis software; LONGITUDINAL method; EVALUATION
- Publication
Orthopaedic Journal of Sports Medicine, 2021, Vol 9, Issue 12, p1
- ISSN
2325-9671
- Publication type
Article
- DOI
10.1177/23259671211059170