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Do Concomitant Chondral Procedures Impact Patient Outcomes Following Arthroscopic Treatment of Femoroacetabular Impingement In Patients With Large Cartilage Lesions?


Ivan Wong, MD, FRCSC, MACM, Dip. Sports Med
CANADA

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Do Concomitant Chondral Procedures Impact Patient Outcomes Following Arthroscopic Treatment of Femoroacetabular Impingement In Patients With Large Cartilage Lesions?

Sara Sparavalo, B.Sc., M.A.Sc., CANADA Jie Ma, CANADA Ivan Wong, MD, FRCSC, MACM, Dip. Sports Med, CANADA

Dalhousie University & Nova Scotia Health Authority, Halifax, Nova Scotia, CANADA

2023 Congress   ePoster Presentation   2023 Congress   Not yet rated

 

Anatomic Location

Hip / Groin / Thigh

Anatomic Structure

Cartilage

Diagnosis / Condition

Impingement

Treatment / Technique

Arthroscopy

Summary: Patients with concomitant chondral procedures have higher rates of THR post-operatively compared to patients without that had treatment for FAI.

Background

Cartilage defects cause pain and functional limitation and are commonly associated with femoroacetabular impingement (FAI). Because chondral defects have almost no capacity to repair themselves, if left untreated they have a high probability of progressing to osteoarthritis. Previously, the outcomes of patients who received microfracture were compared to those who received microfracture with CarGel, and it was found that CarGel results in a lower conversion to total hip replacement (THR). This study did not include a control group without chondral procedures. Therefore, the purpose of this study is to compare the clinical outcomes of patients who received treatment for FAI with no chondral procedures to those that received concomitant treatment for cartilage lesions.

Methods

A retrospective chart review was conducted for patients who underwent arthroscopic treatment for FAI between 2012 and 2019. Patients missing five-year clinical follow-up were excluded. Patients with chondral procedures such as microfracture and/or CarGel were matched to a control group with no chondral procedures based on age (±5 years), BMI (±5.5 kg/m2), and length of clinical follow-up (±2 year). We compared PROs and conversion rate to THR between the two groups.

Results

A total of 160 patients were included both groups (80 in each). The demographics were comparable between the groups. There were statistically significant differences between the groups with respect to chondral defect incidence and size, with higher values in the chondral group (p<0.001). With respect to post-operative conversion to THR, the chondral group had 28.7% rate compared to the control group which had a lower rate (3.8%) (p<0.001). With respect to iHOT-33 scores, both groups improved following surgery, however the post-operative scores were significantly lower in the chondral group (p=0.02).

Conclusion

Patients with concomitant chondral procedures have higher rates of THR post-operatively compared to patients without that had treatment for FAI.

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