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Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXIII | Pages 74 - 74
1 May 2012
Haviv B O'Donnell J
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Introduction

With the evolution of hip arthroscopy, it has been used as joint preserving surgery for osteoarthritis among various other indications. The purpose of this study was to assess the factors that affect the subgroup of patients with osteoarthritis that have had total hip replacements following hip arthroscopy.

Methods

Data was retrieved retrospectively from 556 osteoarthritic patients' files that have had hip arthroscopy between the years 2002 to 2009 (mean follow up time 3.2 – range 1 to 6.4 years). Eighty-three (15%) of them have had eventually total hip replacement. The data analysis included different variables (i.e. age, arthritic stage, repeated procedures) that may have influenced the time elapsed between the hip arthroscopy and consecutive replacement procedures.


Orthopaedic Proceedings
Vol. 93-B, Issue SUPP_II | Pages 149 - 149
1 May 2011
O’donnell J Haviv B Singh P
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Purpose: The purpose of this study was to evaluate the outcome of arthroscopic femoral osteochondroplasty for cam lesions of the hip with respect to the severity of acetabular chondral damage.

Methods: The study is a retrospective review of 170 patients (35 females, 135 males) who underwent surgery for symptomatic cam femoroacetabular impingement (FAI) between the years 2003 to 2008. The patients were categorized according to three different grades of chondral damage. No patients had evidence of labral pathology. Microfracture of the acetabular chondral damage was also performed when indicated. The clinical results in each grade were measured preoperatively and postoperatively with the modified Harris Hip Score (MHHS) and Non Arthritic Hip Score (NAHS).

Results: The mean follow-up time was 22 months (range 12 to 72 months). At the last follow-up, significantly better results were observed in hips with less chondral damage. The mean MHHS improved from 74.1±17.1 to 89.8±11.6 in grade 1 whereas it improved from 62.3±14.3 to 77.4±18.3 in grade 3 (p=0.02). The mean NAHS improved from 70.7±13.5 to 87±16.2 in grade 1 whereas it improved from 60.5±16.2 to 78±17.8 in grade 3 (p=0.04). Microfracture in limited zones of ace-tabular chondral damage had shown superior results.

Conclusions: Arthroscopic femoral osteoplasty for hip cam impingement with acetabular chondral damage provides a significant improvement in symptoms. Microfracture of the chondral lesion in selected cases has been demonstrated to be safe and benifical.


The Journal of Bone & Joint Surgery British Volume
Vol. 92-B, Issue 5 | Pages 629 - 633
1 May 2010
Haviv B Singh PJ Takla A O’Donnell J

This study evaluates the outcome of arthroscopic femoral osteochondroplasty for cam lesions of the hip in the absence of additional pathology other than acetabular chondral lesions. We retrospectively reviewed 166 patients (170 hips) who were categorised according to three different grades of chondral damage. The outcome was assessed in each grade using the modified Harris Hip Score (MHHS) and the Non-Arthritic Hip Score (NAHS).

Overall, at the last follow-up (mean 22 months, 12 to 72), the mean MHHS had improved by 15.3 points (95% confidence interval (CI), 8.9 to 21.7) and the mean NAHS by 15 points (95% CI, 9.4 to 20.5). Significantly better results were observed in hips with less severe chondral damage. Microfracture in limited chondral lesions showed superior results.

Arthroscopic femoral osteochondroplasty for cam impingement with microfracture in selected cases is beneficial. The outcome correlates with the severity of acetabular chondral damage.