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Effect Of Femoral And Acetabular Version On Outcomes Following Hip Arthroscopy: A Systematic Review And Meta-Analysis

Casey Wang, MD, CANADA Dan Cohen, MD, CANADA Jeffrey Kay, MD, CANADA Mahmoud Almasri, MD, FRCSC, UNITED STATES Nicole Simunovic, MSc, CANADA Carlomagno Cardenas-Nylander, MD, SPAIN Anil S. Ranawat, MD, UNITED STATES Olufemi R. Ayeni, MD, PhD, MSc, FRCSC, CANADA

McMaster University, Hamilton, Ontario, CANADA

2021 Congress Abstract Presentation 9 minutes Not yet rated

Anatomic Location

Hip / Groin / Thigh

Diagnosis / Condition

Impingement

Treatment / Technique

Arthroscopy

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Summary: This systematic review of the literature indicates that while acetabular or femoral retroversion yield similar outcomes following hip arthroscopy to patients with normal acetabular or femoral version, patients with excess femoral anteversion had mixed functional outcomes postoperatively and higher rates of conversion to total hip arthroplasty (THA) at final follow-up.

Purpose

The purpose of this systematic review was to evaluate the impact of femoral and acetabular version on clinical outcomes following arthroscopic hip surgery.

Methods

Three databases (MEDLINE, EMBASE, and PubMed) were searched by two reviewers independently on December 15, 2020. Titles, abstracts, and full-text articles were screened in duplicate. Studies examining femoral and acetabular version in primary hip arthroscopy with patient-reported outcomes were included. The Methodological Index For Non-Randomized Studies (MINORS) instrument was used for quality assessment of studies. A random effects model was used to pool comparative post-operative outcomes between groups.

Results

Overall, 14 studies met the inclusion criteria and comprised 1754 patients (1763 hips), 1062 femora, and 701 acetabula, with a mean age of 29.8 (range 14-74.7) and mean follow-up of 40.4 months (range 4.8-113.4). Femoral version was measured on cross-sectional imaging in all studies investigating femur-based abnormalities. The most common lower bound defined for normal femoral version was 5 degrees, while the most common upper bound was 20 degrees. Patients with femoral retroversion had no significant difference in postoperative outcomes compared to those with normal version with mean differences (95% CI, p-value) in post-operative mHHS, HOS-SSS, VAS and NAHS scores of 1.68 (-3.19 to 6.54, p=0.50), 4.03 (-3.29 to 11.35, p=0.18), 0.05 (-0.42 to 0.53, p=0.82), and 3.38 (-1.96 to 8.71, p=0.22), respectively. In the high femoral anteversion groups, the mean difference (95% CI, p-value) in post-operative mHHS score was significantly lower than in the normal version groups [–4.28 (-8.20 to -0.37, p=0.03)] while there was no significant difference in the mean difference in post-operative HOS-SSS [-7.82 (-21.98 to 6.34, p=0.08)]. Of note, conversion rate to THA at final follow-up was 7.7% (n=11) in patients with femoral retroversion, and 13.6% (n=6) in patients with high femoral anteversion. In the acetabular retroversion group, there were no significant differences noted postoperatively for the VAS, mHHS, and HOS-SSS scores compared the groups with normal acetabular version.

Conclusion

While the definition of normal version of the hip varied within the literature, arthroscopic surgery in patients with femoral or acetabular retroversion generally resulted in equivalent functional and radiographic outcomes when compared to patients with normal version. However, patients with retroverted femora also had important conversion rates to total hip arthroplasty (THA). Postoperative functional outcomes in patients with high femoral anteversion compared to patients with normal femoral version were largely inconclusive, yet rates of conversion to THA were even higher in excessively anteverted femora. Further prospective studies would be useful in identifying precise surgical indications for safe arthroscopic surgery in patients with version abnormalities of the femur and acetabulum, particularly those with femoral anteversion.

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The Effect Of Osteochondroplasty On Time To Reoperation After Arthroscopic Management Of Femoroacetabular Impingement Abstract Presentation 5 minutes Jeffrey Kay, MD, CANADA Nicole Simunovic, MSc, CANADA Olufemi R. Ayeni, MD, PhD, MSc, FRCSC, CANADA FIRST Investigators, MD, CANADA
Promis Mobility: Evaluation Of The Lower Extremity-Specific Instrument In A Sports Medicine Hip Registry ePoster Presentation Molly A Day, MD, UNITED STATES Ryan S. Selley, MD, UNITED STATES Kyle Hancock, MD, UNITED STATES Reena Olsen, BS, UNITED STATES Danyal H. Nawabi, MD, FRCS(Orth), UNITED STATES Benedict U. Nwachukwu, MD, MBA, UNITED STATES Stephanie S Buza, MD, UNITED STATES Anil S. Ranawat, MD, UNITED STATES Bryan T. Kelly, MD, UNITED STATES
The Radiographical Influence Of Torsional Deformity Of The Acetabular And Femur In Dysplastic Hips ePoster Presentation Carsten Heimer, BA, GERMANY Carsten Perka, MD, PhD, GERMANY Henrik Baecker, MD, GERMANY
The Relationship Between Early And Mid-Term Hip Arthroscopy Outcomes: Employing 3 Month Follow-Up To Predict Mid-Term Results Abstract Presentation 5 minutes Mario Hevesi, MD, PhD, UNITED STATES Ajay C. Lall, MD, MS, FAAOS, UNITED STATES David E. Hartigan, MD, UNITED STATES Bruce A. Levy, MD, UNITED STATES Benjamin G. Domb, MD, UNITED STATES Aaron J. Krych, MD, UNITED STATES
Similar Joint Space Measurements Are Obtained With Supine And Weightbearing Anteroposterior Pelvis Radiographs: Results Of A Prospective Study Abstract Presentation 5 minutes Blake M. Bodendorfer, MD, UNITED STATES Vishal A. Mehta, DO, UNITED STATES Austin M Looney, MD, UNITED STATES Kenneth Tepper, MD, UNITED STATES
Defining Sex-Based Outcomes Following Hip Arthroscopy In Patients With Borderline Hip Dysplasia. ePoster Presentation Benjamin Saks, MD, UNITED STATES James Fox, BBA, UNITED STATES Jade S Owens, BS, UNITED STATES Andrew Jimenez, MD, UNITED STATES Hari Krishna Ankem, MD, UNITED STATES Payam William Sabetian, MD, GUATEMALA Ajay C. Lall, MD, MS, FAAOS, UNITED STATES Benjamin G. Domb, MD, UNITED STATES
Stem Cells Injection And Percutaneous Femoral Head Decompression - An Extremely Rare Procedure With Good Results ePoster Presentation Sofia Moura De Carvalho, MD, PORTUGAL Inês Domingues, MD, PORTUGAL Liliana Domingues, MD, PORTUGAL Eduardo Ramalho Silva, MD, PORTUGAL Gonçalo Lavareda, MD, PORTUGAL Filipe Machado, MD, PORTUGAL Rita Ricardo, MD, PORTUGAL
No Difference In Minimum Two-Year Patient-Reported Outcome Scores Between Circumferential And Segmental Labral Reconstruction For The Management Of Irreparable Labral Tear And Femoroacetabular Impingement Syndrome In The Primary Setting. ePoster Presentation David R. Maldonado, MD, UNITED STATES Cynthia Kyin, BA, UNITED STATES Jacob Shapira, MD, UNITED STATES Mitchell Meghpara, MD, UNITED STATES Philip Joseph Rosinsky, MD, UNITED STATES Ajay C. Lall, MD, MS, FAAOS, UNITED STATES Benjamin G. Domb, MD, UNITED STATES
“X-Square” Technique For Radial Meniscal Root Tear ePoster Presentation Winyou Ratanachai, MD.M Ch(Orth)., THAILAND Keerati Klinchanhom, MD, THAILAND
Sex- And Age-Based Differences In Outcomes And Survivorship Following Primary Hip Arthroscopy At Short And Mid-Term Follow-Up: A Comparative Analysis ePoster Presentation David R. Maldonado, MD, UNITED STATES Jade S Owens, BS, UNITED STATES Cammille Go, BA, UNITED STATES Benjamin G. Domb, MD, UNITED STATES
Characterizing the Incidence of Avascular Necrosis after Corticosteroid Injections of the Hip Abstract Presentation 5 minutes Nathan Varady, MD, MBA, UNITED STATES Paul F Abraham, BS, UNITED STATES Ahab Chopra, BA, UNITED STATES Michael Peter Kucharik, BS, UNITED STATES Wendy Madeline Meek, BBA, UNITED STATES Christopher T Eberlin, BS, UNITED STATES David Freccero, MD, UNITED STATES Eric L. Smith, MD, UNITED STATES Scott D Martin, MD, UNITED STATES
Hip Osteochondroplasty May Benefit The Non-Ideal Patient With Femoroacetabular Impingement: Analysis From The Embedded Prospective Cohort Of The First Trial Abstract Presentation 6 minutes Mahmoud Almasri, MD, FRCSC, UNITED STATES Nicole Simunovic, MSc, CANADA Diane Heels-Ansdell, MSc, CANADA Olufemi R. Ayeni, MD, PhD, MSc, FRCSC, CANADA FIRST Investigators, MD, CANADA
Results After Arthroscopic Treatment Of Iliopsoas Impingement After Total Hip Arthroplasty ePoster Presentation Wolfgang Miehlke, MD, GERMANY Christian Sobau, MD, GERMANY Alexander Zimmerer, MD, GERMANY
Persistent Post-Operative Opioid Use Following Hip Arthroscopy Is Common And Is Associated With Pre-Operative Opioid Use And Age ePoster Presentation Ryan M. Degen, MD, FRCSC, CANADA J. Andrew McClure, MSc, CANADA Britney Le, MSc, CANADA Blayne Welk, MD, CANADA Jacquelyn Marsh, PhD, CANADA
Treatment of Bilateral Hip Femoroacetabular Impingement: Simultaneous or Staged? Abstract Presentation 5 minutes Gen Lin Foo, MD, SINGAPORE Catherine J. Bacon, PhD, MSc, BSc, BPhed(Hons), NEW ZEALAND Matthew J. Brick, MBChB, FRACS, NEW ZEALAND
Arthroscopic Tendon Release for Iliopsoas Impingement after Total Hip Arthroplasty ePoster Presentation Michael Andreas Finsterwald, MD, AUSTRALIA Georgina Waters, MD, AUSTRALIA Jay R. Ebert, PhD, AUSTRALIA Christopher W. Jones, FAOrthA FRACS PhD MBBS(Hons) BEng(Hons) BCom, AUSTRALIA Piers Yates, MBBS(Hons) BSc(Hons) MRCS(Eng) FRCS(Tr & Orth) FRA, AUSTRALIA Peter Alberto D'Alessandro, MBBS Hons. (UWA) FRACS FAOrthA, AUSTRALIA
Covid Mortality Among Neck Of Femur Fractures During The Pandemic 2019 Abstract Presentation 5 minutes Aashish Raghu, MBBS, MS, MRCS, FRCS (Tr & Orth), UNITED KINGDOM Anas Hassan, MBBS, MRCS, UNITED KINGDOM Nicholas Dr Roeck, MB ChB, FRCS (ENG), FRCS (Tr&Orth), UNITED KINGDOM Mohamed Antar, MBBS, Master of Orthopaedics, MRCS, UNITED KINGDOM
Hip Disorders in Bull Riders: Clinical Observations and Outcomes of Arthroscopy Abstract Presentation 6 minutes J.W. Thomas Byrd, MD, UNITED STATES Kay S. Jones, MSN, RN, UNITED STATES
Risk Of Conversion To Arthroplasty Following Hip Arthroscopy: Validation Of A Published Risk Score Using An Independent, Prospectively Collected Database Abstract Presentation 4 minutes Mario Hevesi, MD, PhD, UNITED STATES Devin Leland, MD, UNITED STATES Philip Joseph Rosinsky, MD, UNITED STATES Ajay C. Lall, MD, MS, FAAOS, UNITED STATES Benjamin G. Domb, MD, UNITED STATES David E. Hartigan, MD, UNITED STATES Bruce A. Levy, MD, UNITED STATES Aaron J. Krych, MD, UNITED STATES

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Effect Of Femoral And Acetabular Version On Outcomes Following Hip Arthroscopy: A Systematic Review And Meta-Analysis

Effect Of Femoral And Acetabular Version On Outcomes Following Hip Arthroscopy: A Systematic Review And Meta-Analysis

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Effect Of Femoral And Acetabular Version On Outcomes Following Hip Arthroscopy: A Systematic Review And Meta-Analysis

Effect Of Femoral And Acetabular Version On Outcomes Following Hip Arthroscopy: A Systematic Review And Meta-Analysis

Purpose

Methods

Results

Conclusion

More ISAKOS 2021: Global Content