Summary

acetabular depth-to-width ratio and chondral injury level as key predictors for progression to total hip arthroplasty following hip arthroscopy

Abstract

Background

Hip arthroscopy has become a prevalent intervention for addressing various intra-articular pathologies. However, the long-term outcomes, including the risk of progression to total hip arthroplasty (THA), remain under investigation. This study aims to identify predictive factors for THA in patients who underwent hip arthroscopy, with a focus on demographic, radiographic, and intraoperative variables.

Methods

We retrospectively analyzed 209 patients who underwent hip arthroscopy performed by a single surgeon over a 10-year period. The analysis focused on the association between the need for subsequent THA and variables including gender, age, side, ligamentum teres tear, Tonnis grade, lateral center-edge angle (LCEA), femoroacetabular impingement index (FEAR index), neck shaft angle, proximal femur angle, Sharp angle, acetabular width, alpha angle, version in AP view, version in frog view, acetabular depth-to-width ratio, acetabular head index, anterior joint space width, and chondral injury.

Results

Among the variables analyzed, the acetabular depth-to-width ratio (Coefficient: -16.996, p-value: 0.000), chondral injury level (Coefficient: 1.128, p-value: 0.050), and Tonnis grade (Coefficient: 0.231, p-value: 0.583) were most significantly associated with the likelihood of progressing to THA. The acetabular depth-to-width ratio demonstrated the strongest inverse correlation, suggesting that a lower ratio may be predictive of increased risk for THA. The presence of chondral injury also showed a borderline significant correlation with THA.

Conclusion

This study identifies the acetabular depth-to-width ratio and chondral injury level as key predictors for progression to total hip arthroplasty following hip arthroscopy. These findings underscore the importance of thorough preoperative assessment and highlight the potential for certain anatomical and injury-related factors to influence long-term outcomes. Further studies are warranted to confirm these results and refine patient selection criteria for hip arthroscopy.