Severe chondrolabral wear may increase risk of conversion to THA
Click Here to Manage Email Alerts
Key takeaways:
- Severe chondrolabral wear was an independent risk factor of conversion to total hip arthroplasty.
- Older age and combined femoroacetabular impingement type may also increase conversion to total hip arthroplasty.
WASHINGTON — Results presented here showed grade 4 degeneration of the chondrolabral junction was an independent risk factor for conversion to total hip arthroplasty among patients with femoroacetabular impingement.
“No studies to date have correlated the stages of chondrolabral junction wear with failure of femoroacetabular impingement (FAI) and labral tear treatment,” Wang said in his presentation at the American Orthopaedic Society for Sports Medicine Annual Meeting. “Therefore, the purpose of this study was to identify the location and severity of intraoperative pathology at time of arthroscopic surgery for FAI as risk factors for conversion to total hip arthroplasty utilizing long-term follow-up.”
In a retrospective study of prospectively collected data, Charles Wang, MD, and colleagues identified 109 adults who underwent hip arthroscopy for FAI between 1998 and 2011 with a minimum 10-year follow-up.
“Intraoperative measurements included an Outerbridge grade, location of most severe chondral wear, presence of a chondral flap, degree of the chondrolabral degeneration and type of labral management, whether it was labral debridement or repair,” Wang said.
Baseline demographic findings showed a significant association between older age, a lower Tönnis angle and types of FAI with conversion to THA, according to Wang. He added intraoperative findings showed a significant association between Outerbridge grade 4 and posterior-superior anatomic wear with conversion to THA. Multivariable logistic regression models using both baseline and intraoperative variables showed older age, grade 4 chondrolabral wear and combined FAI type were significant risk factors for conversion to THA.
“This study does beg the question of, ‘Is it prudent to manage FAI prior to the [chondrolabral] delamination or the point of no return?’” Wang said. “It also gives more emphasis on the need to specifically focus on how we can get this delaminated chondrolabral junction to heal.”
Collapse
Wang C, et al. Paper 12. Presented at: American Orthopaedic Society for Sports Medicine Annual Meeting; July 12-16, 2023; Washington, D.C.
Click Here to Manage Email Alerts