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Patients with FAI, Tönnis grade 2 may have improvements after arthroscopic management
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Patients with Tönnis grade 2 who underwent femoroacetabular impingement correction with arthroscopic management had statistically and clinically significant improvements in outcomes, as well as no significantly different patient-reported outcomes compared with those who had Tönnis grade 0 or 1, according to recently published results.
J.W. Thomas Byrd, MD, and colleagues correlated previously reported modified-Harris hip scores of 100 consecutive patients who underwent arthroscopic femoroacetabular impingement (FAI) corrections with Tönnis grades that were independently determined by two experienced clinicians. Researchers compared cases with Tönnis grades 0 and 1 with Tönnis grade 2 and evaluated independent variables of sex and age.
Results showed an average age of 34.7 years among 66 men and 34 women, as well as Tönnis grade 0 in 17 patients, Tönnis grade 1 in 49 patients, Tönnis grade 2 in 29 patients, Tönnis grade 3 in four patients and one unknown Tönnis grade. Researchers found statistically and clinically significant improvements across all Tönnis grades, with an average improvement in modified-Harris hip score of 20.6 points, 22.2 points, 14.9 points and 18.8 points for patients who had Tönnis grade 0, Tönnis grade 1, Tönnis grade 2 and Tönnis grade 3, respectively. According to results, Tönnis grade 2 had no differences in outcomes compared with Tönnis grades 0 and 1. Researchers also noted no differences based on sex or age.
“Tönnis [grade] 2 radiographic changes, by themselves, are not a contraindication to arthroscopic management of femoroacetabular impingement,” Byrd told Healio.com/Orthopedics. “With proper patient selection, clinically meaningful improvement can be accomplished. Of course, the results are more favorable for those with Tönnis [grade] 0 or 1 changes, but that does not mean that arthroscopic surgery cannot help, even with Tönnis [grade] 2 changes are present.” – by Casey Tingle
Disclosures: Byrd reports he receives support from Smith & Nephew and A3 Surgical. Please see the full study for a list of all other authors’ relevant financial disclosures.
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