Hip chondropathy at arthroscopy: prevalence and relationship to labral pathology, femoroacetabular impingement and patient-reported outcomes

• Published in: British journal of sports medicine Vol. 48; no. 14; p. 1102
• Main Authors: Kemp, Joanne L, Makdissi, Michael, Schache, Anthony G, Pritchard, Michael G, Pollard, Thomas C B, Crossley, Kay M
• Format: Journal Article
• Language: English
• Published: England 01-07-2014
• Subjects: Adolescent; Adult; Age Distribution; Arthroscopy; Cartilage Diseases - etiology; Epidemiologic Methods; Female; Femoracetabular Impingement - complications; Humans; Male; Middle Aged; Musculoskeletal Pain - etiology; Musculoskeletal Pain - surgery; Osteoarthritis, Hip - etiology; Patient Outcome Assessment; Postoperative Complications - etiology; Treatment Outcome; Young Adult; Hip disorder; Osteoarthritis; Arthroscopic Surgery
• ISSN: 1473-0480
• DOI: 10.1136/bjsports-2013-093312

This study aimed to describe chondropathy prevalence in adults who had undergone hip arthroscopy for hip pain. The relationships between chondropathy severity and (1) participant characteristics; and (2) patient-reported outcomes (PROs) at initial assessment (∼18 months postsurgery) and over a further 12 months (∼30 months postsurgery) were evaluated. Finally, the relationships between chondropathy and coexisting femoroacetabular impingement (FAI) and labral pathology at the time of surgery were evaluated.
100 consecutive patients (36±12 years) who underwent hip arthroscopy 18 months previously participated. Hip Osteoarthritis and Disability Outcome Score (HOOS) and International Hip Outcome Tool (iHOT-33) data were collected prospectively at 18 months postsurgery and at 30 months postsurgery. Surgical data were collected retrospectively. Participants were grouped: Outerbridge grade 0, no chondropathy; Outerbridge grade I-II, mild chondropathy; Outerbridge III-IV, severe chondropathy. The presence of FAI or labral pathology was noted.
The prevalence of chondropathy (≥grade I) at hip arthroscopy was 72%. Participants with severe chondropathy were significantly worse for all HOOS subscales and the iHOT-33 at 18 months postsurgery (HOOS-symptoms (p=0.017); HOOS-pain (p=0.024); HOOS-activity (p=0.009); HOOS-sport (p=0.004); HOOS-quality-of-life (p=0.006); iHOT-33 (p=0.013)) than those with no chondropathy. At 12-month follow-up, HOOS-quality-of-life in those without chondropathy was the only PRO that improved. Relative risk of coexisting chondropathy with labral pathology or FAI was 40%.
Chondropathy was prevalent, and associated with increasing age, coexisting labral pathology or FAI. Severe chondropathy was associated with worse pain and function at 18 months postsurgery. Little improvements were observed in participants over a further 12 months, regardless of chondropathy status.