J Arthroplasty. 2022 Apr 8:S0883-5403(22)00393-X. doi: 10.1016/j.arth.2022.04.002. Online ahead of print.
ABSTRACT
BACKGROUND: Acetabular retroversion may predispose to more severe Femoroacetabular Impingement Syndrome (FAIS) and early labral damage given impaction of the femoral head-neck junction on the retroverted acetabular rim. The cross-over sign (COS), posterior wall sign (PWS), and ischial spine sign (ISS) are markers of acetabular retroversion (AR) on plain radiographs.
METHODS: Patients who underwent primary hip arthroscopy for FAIS from 01/2012 to 12/2018 with a positive PWS were matched 1:1 by age, gender, and BMI to controls with a negative PWS. Pre- and postoperative patient-reported outcomes (PROs; HOS-ADL, HOS-SS, mHHS and iHOT-12) were compared using independent t-tests. Achievement of a Patient Acceptable Symptom State (PASS) or Minimal Clinically Important Difference (MCID) was compared using Fisher’s exact.
RESULTS: 275 patients with a positive PWS and 275 controls were included in the final analysis. Majority of patients (64%) were female, average age, and BMI of 37.6 (SD 8.6) and 25.1 (SD 4.4), respectively. PROs improved significantly for both groups from preoperatively to 2-years postoperatively. There were no statistically significant differences (P≥0.05) in PROs or achievement of MCID or PASS. On subgroup analysis, patients with all three positive signs had significantly lower postoperative PROs, and lower rates of achievement of MCID and PASS.
CONCLUSION: Patients with an isolated PWS achieve similar outcomes following hip arthroscopy at 2-years. However, patients with a concomitant PWS, ISS, and COS demonstrate less favorable outcomes, suggesting the need for increased perioperative counseling and potential evaluation for planned concurrent or serial open procedures such as periacetabular osteotomy.
PMID:35405263 | DOI:10.1016/j.arth.2022.04.002
