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Patients with FAI, borderline dysplasia may have higher risk of Outerbridge chondral damage
Compared with patients with non-borderline dysplastic hips, results showed patients with femoroacetabular impingement and borderline dysplasia had a higher risk of Outerbridge grade 3 and 4 chondral damage on the femoral head.
“Borderline acetabular dysplasia is not uncommon in patients with femoroacetabular impingement [FAI],” Ioanna K. Bolia, MD, co-author of the study told Healio.com/Orthopedics. “This study shows that mild acetabular dysplasia contributes to the damage of the hip joint cartilage and it is a risk factor for degenerative joint disease.”
Bolia and colleagues categorized 2,429 patients who underwent primary hip arthroscopy for correction of FAI and labral repair into a borderline (n=305) or non-borderline (n=2,124) group based on whether they had a lateral center-edge angle between 20° and 25° or a lateral center-edge angle between 25° and 40°, respectively. Researchers recorded the prevalence, size and location of Outerbridge grade 3 and 4 chondral lesions on the femoral head and acetabulum intraoperatively.
Results showed 39% of patients with borderline dysplasia had Outerbridge grade 3 and 4 chondral lesions on the femoral head vs. 6% of patients with non-borderline dysplasia. Researchers also found 43% and 41% of patients in the borderline and non-borderline groups, respectively, had Outerbridge grade 3 and 4 chondral lesions on the acetabulum. Compared with patients in the non-borderline dysplasia group, according to results, a grade 3 or 4 cartilage defect was 10-times more likely to occur on the weight-bearing surface of the femoral head in the borderline dysplasia group. However, researchers noted no differences between the two groups when it came to the prevalence of severe cartilage damage on the acetabular side. Results showed patients with borderline dysplasia on the acetabulum had a significantly greater size of chondral damage vs. the non-borderline dysplasia group.
“Patients with FAI and borderline dysplasia are more likely to present with severe cartilage changes of the femoral head compared to non-dysplastic patients, but the prevalence of such lesions on the acetabular chondral surface does not differ significantly between the aforementioned patient populations,” Bolia said. “However, borderline dysplastic patients with FAI have significantly larger cartilage defects on the acetabulum compared to the non-dysplastic [patients]. Thus, mild hip dysplasia increases the risk of more extensive cartilage damage on the acetabular surface, and the surgeon should anticipate this finding during hip arthroscopy. Subsequently, repairing the chondral defects in dysplastic patients with FAI should not be omitted to maximize the efficacy of a hip preservation procedure.” – by Casey Tingle
Disclosures: Bolia reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.