2025 ISAKOS Biennial Congress ePoster
Congenitally Narrow Joint Space Does Not Portend Inferior Outcomes After Hip Arthroscopy
Benjamin D Kuhns, MD, MS, Des Plaines, Illinois UNITED STATES
Tyler R. McCarroll, MD, Des Plaines, IL UNITED STATES
Yasemin E. Kingham, BA, Des Plaines, IL UNITED STATES
Jessica C. Keane, BS, Des Plaines, IL UNITED STATES
Benjamin G. Domb, MD, Des Plaines, Illinois UNITED STATES
American Hip Institute Research Foundation, Des Plaines, Illinois, UNITED STATES
FDA Status Cleared
Summary
Patients with a congenitally narrowed hip joint space < 3mm without evidence of osteoarthritis have improved outcomes following arthroscopic surgery for femoroacetabular impingement without differences in outcomes or arthroplasty rates compared to a propensity matched cohort.
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Abstract
Introduction
Hip preservation surgery is often contraindicated in the setting of decreased radiographic joint space. The purpose of this study was to evaluate the outcomes of hip preservation surgery in patients with a symmetric congenitally narrowed hip joint space without radiographic evidence of degenerative changes.
Methods
Consecutive patients with radiographic joint space less than 3mm and a Tonnis grade of 0 undergoing hip arthroscopy with labral repair and correction of femoroacetabular impingement were included in this study. This cohort was propensity matched to patients with an average joint space greater than 4mm. Preoperative demographic and radiographic variables, intraoperative findings and procedures, and minimum five-year postoperative outcomes were compared between the two groups.
Results
78 patients were included in each group. There were no differences in age, gender, BMI, or radiographic variables other than joint space width between cohorts. The congenitally narrow group had an average joint space width of 2.7±0.2mm compared to 4.7±0.5mm (p<0.001). The congenitally narrow group had lower rates of severe (Outerbridge grade III/IV) femoral head chondral damage than the control cohort (0% vs. 9%; p=0.02), but no significant differences in acetabular cartilage quality. There was significant improvement for both groups with no differences in patient reported outcome scores, achievement of clinically relevant or satisfaction with surgery (p>0.05 for all). There were no differences in rates of secondary surgery between groups (2 patients requiring arthroplasty in both groups; 2.6%).
Conclusions
Patients with a congenitally narrowed hip joint space < 3mm without evidence of osteoarthritis have improved outcomes following arthroscopic surgery for femoroacetabular impingement without differences in outcomes or arthroplasty rates compared to a propensity matched cohort. Care should be taken to rule out early hip osteoarthritis with advanced imaging or serial radiographs when indicating patients with narrow joint space for hip preservation surgery.