Several factors predict grade IV chondral defects in the hip

CHICAGO — Several factors were associated with grade IV chondral defects in patients undergoing hip arthroscopy, according to results presented at the International Cartilage Repair Society Annual Meeting.

“The presence of grade IV chondral defects in arthroscopy in symptomatic patients was correlated with less than 2 mm in joint space, age greater than 45 years, male sex, larger alpha angle greater than 55°, as well as a longer duration of symptoms greater than 36 months,” Sanjeev Bhatia, MD, of the Steadman Clinic, said in his presentation here.

Sanjeev Bhatia

Bhatia and colleagues identified 1,097 patients, 606 men and 491 women, who underwent hip arthroscopy for pain, had no prior hip surgery, and had presence and grade of cartilage defects recorded. The researchers noted clinically preoperative physical exam findings, duration of symptoms, type of sport and the presence of traumatic etiology.

Overall, results showed 28% of hips presented with grade IV chondral defects, with 80% of the defects present on the articular surface.

“As far as location of grade IV chondral defects go on the acetabular side, 94.7% of the time it was in the anterior superior aspect of the acetabulum,” Bhatia said. “On the femoral side, chondral defects were more evenly dispersed.”

Bhatia noted an increased duration of symptoms greater than 36 months was significantly associated with a grade IV chondral defect. Results also showed patients older than 45 years of age were 2.5 times more likely to have a grade IV chondral defect at the time of surgery.

“Those with joint space less than 2 mm were eight times more likely to have a grade IV chondral defect at the time of arthroscopy,” Bhatia said. “Additionally, patients who had a significantly higher mean alpha angle were significantly more likely to have grade IV defect at arthroscopy.”

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Since men had a higher alpha angle on average vs. women, Bhatia said the men had a significantly greater risk of developing grade IV chondral defects at the time of arthroscopy.

“This information … helps us better counsel our patients in that we can identify the risk factors for having grade IV chondral defects,” Bhatia said. – by Casey Tingle

Reference:

Bhatia S, et al. Predictors of cartilage lesions in hips with femoroacetabular impingement. Presented at: International Cartilage Repair Society Annual Meeting. May 8-11, 2015; Chicago.

Disclosure: Bhatia reports no relevant financial disclosures.