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Effect Of Femoral And Acetabular Version On Outcomes Following Hip Arthroscopy: A Systematic Review And Meta-Analysis

Casey Wang, MD, CANADA Dan Cohen, MD, CANADA Jeffrey Kay, MD, CANADA Mahmoud Almasri, MD, FRCSC, UNITED STATES Nicole Simunovic, MSc, CANADA Carlomagno Cardenas-Nylander, MD, SPAIN Anil S. Ranawat, MD, UNITED STATES Olufemi R. Ayeni, MD, PhD, MSc, FRCSC, CANADA

McMaster University, Hamilton, Ontario, CANADA

2021 Congress Abstract Presentation 9 minutes Not yet rated

Anatomic Location

Hip / Groin / Thigh

Diagnosis / Condition

Impingement

Treatment / Technique

Arthroscopy

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Summary: This systematic review of the literature indicates that while acetabular or femoral retroversion yield similar outcomes following hip arthroscopy to patients with normal acetabular or femoral version, patients with excess femoral anteversion had mixed functional outcomes postoperatively and higher rates of conversion to total hip arthroplasty (THA) at final follow-up.

Purpose

The purpose of this systematic review was to evaluate the impact of femoral and acetabular version on clinical outcomes following arthroscopic hip surgery.

Methods

Three databases (MEDLINE, EMBASE, and PubMed) were searched by two reviewers independently on December 15, 2020. Titles, abstracts, and full-text articles were screened in duplicate. Studies examining femoral and acetabular version in primary hip arthroscopy with patient-reported outcomes were included. The Methodological Index For Non-Randomized Studies (MINORS) instrument was used for quality assessment of studies. A random effects model was used to pool comparative post-operative outcomes between groups.

Results

Overall, 14 studies met the inclusion criteria and comprised 1754 patients (1763 hips), 1062 femora, and 701 acetabula, with a mean age of 29.8 (range 14-74.7) and mean follow-up of 40.4 months (range 4.8-113.4). Femoral version was measured on cross-sectional imaging in all studies investigating femur-based abnormalities. The most common lower bound defined for normal femoral version was 5 degrees, while the most common upper bound was 20 degrees. Patients with femoral retroversion had no significant difference in postoperative outcomes compared to those with normal version with mean differences (95% CI, p-value) in post-operative mHHS, HOS-SSS, VAS and NAHS scores of 1.68 (-3.19 to 6.54, p=0.50), 4.03 (-3.29 to 11.35, p=0.18), 0.05 (-0.42 to 0.53, p=0.82), and 3.38 (-1.96 to 8.71, p=0.22), respectively. In the high femoral anteversion groups, the mean difference (95% CI, p-value) in post-operative mHHS score was significantly lower than in the normal version groups [–4.28 (-8.20 to -0.37, p=0.03)] while there was no significant difference in the mean difference in post-operative HOS-SSS [-7.82 (-21.98 to 6.34, p=0.08)]. Of note, conversion rate to THA at final follow-up was 7.7% (n=11) in patients with femoral retroversion, and 13.6% (n=6) in patients with high femoral anteversion. In the acetabular retroversion group, there were no significant differences noted postoperatively for the VAS, mHHS, and HOS-SSS scores compared the groups with normal acetabular version.

Conclusion

While the definition of normal version of the hip varied within the literature, arthroscopic surgery in patients with femoral or acetabular retroversion generally resulted in equivalent functional and radiographic outcomes when compared to patients with normal version. However, patients with retroverted femora also had important conversion rates to total hip arthroplasty (THA). Postoperative functional outcomes in patients with high femoral anteversion compared to patients with normal femoral version were largely inconclusive, yet rates of conversion to THA were even higher in excessively anteverted femora. Further prospective studies would be useful in identifying precise surgical indications for safe arthroscopic surgery in patients with version abnormalities of the femur and acetabulum, particularly those with femoral anteversion.

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Treatment Modalities And Outcomes Following Acetabular Fractures In The Elderly: A Systematic Review Abstract Presentation 3 minutes Brian McCormick, MD, UNITED STATES Joseph Serino, MD, UNITED STATES Sebastian Orman, MD, UNITED STATES Alex R. Webb, MD, UNITED STATES David X. Wang, MD, UNITED STATES Sharri Mortenson, MD, UNITED STATES Arvind Von Keudell, MD, UNITED STATES
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Does MRI Scan Enable Optimally Informed Pre-Operative Planning In Hip Arthroscopy? Abstract Presentation 5 minutes Vitali Goriainov, FRCS (Orth), BM, PhD, MSc, UNITED KINGDOM Fadi Hindi, BM, MRCS, UNITED KINGDOM Andrew Langdown, BSc MB ChB FRCS(Tr&Orth), UNITED KINGDOM
Natural History Of Femoroacetabular Impingement: Using Machine Learning To Evaluate Risk Factors For Osteoarthritis In A Large Geographic Population Over The Long-Term Abstract Presentation 5 minutes Ayoosh Pareek, MD, UNITED STATES Sunho Ko, MD, KOREA, NORTH Heath Melugin, MD, UNITED STATES Changwung Jo, MD, KOREA, REPUBLIC OF Ryan R Wilbur, BS, UNITED STATES Bryant M. Song, MS, UNITED STATES Aaron J. Krych, MD, UNITED STATES
Risk Factors For Early Conversion To Hip Arthroplasty Following Hip Arthroscopy: A Matched Cohort Analysis Abstract Presentation 4 minutes Joseph J. Ruzbarsky, MD, UNITED STATES Max Seiter, MD, UNITED STATES Rui Soares, BS, UNITED STATES Lauren Pierpoint, PhD, UNITED STATES Karen K. Briggs, MPH, MBS, UNITED STATES Marc J. Philippon, MD, UNITED STATES
Midterm Outcomes Following Hip Labral Augmentation Abstract Presentation 4 minutes Joseph J. Ruzbarsky, MD, UNITED STATES Rui Soares, BS, UNITED STATES Justin W. Arner, MD, UNITED STATES Lauren Pierpoint, PhD, UNITED STATES Maitland Martin, BS, UNITED STATES Spencer M Comfort, BS, UNITED STATES Marc J. Philippon, MD, UNITED STATES
Assessing The Risk Of Osteoarthritis Progression And Femoral Head Collapse Following Hip Corticosteroid/Anesthetic Injection Abstract Presentation 5 minutes Paul F Abraham, BS, UNITED STATES Nathan Varady, MD, MBA, UNITED STATES Kirstin Small, MD, UNITED STATES Nehal Shah, MD, UNITED STATES Luis S Beltran, MD, UNITED STATES Michael Peter Kucharik, BS, UNITED STATES Christopher T Eberlin, BS, UNITED STATES Wendy Madeline Meek, BBA, UNITED STATES Scott D Martin, MD, UNITED STATES
Radiographic Indices Are Not Predictive Of Clinical Outcome Among 1,735 Patients Indicated For Hip Arthroscopy: A Machine Learning Analysis Abstract Presentation 5 minutes Prem N Ramkumar, MD, MBA, UNITED STATES Jaret M Karnuta, MS, UNITED STATES Heather S Haeberle, MD, UNITED STATES Spencer Sullivan, BS, UNITED STATES Danyal H. Nawabi, MD, FRCS(Orth), UNITED STATES Anil S. Ranawat, MD, UNITED STATES Bryan T. Kelly, MD, UNITED STATES Benedict U. Nwachukwu, MD, MBA, UNITED STATES
Utilizing Laser Doppler Flowmetry To Measure Labral Blood Flow During Arthroscopic Acetabular Labral Repair Abstract Presentation 5 minutes Paul F Abraham, BS, UNITED STATES Mark R. Nazal, MPH, UNITED STATES Nathan Varady, MD, MBA, UNITED STATES Michael Peter Kucharik, BS, UNITED STATES Christopher T Eberlin, BS, UNITED STATES Stephen M Gillinov, AB, UNITED STATES Wendy Madeline Meek, BBA, UNITED STATES Scott D Martin, MD, UNITED STATES
Are Femoral And Tibial Derotation Osteotomies Effective In Improving Hip And Knee Pain And Function? Abstract Presentation 5 minutes Vitali Goriainov, FRCS (Orth), BM, PhD, MSc, UNITED KINGDOM Mohamed Zubair Farook, MBBS, D.Ortho, FRCS (Orth), UNITED KINGDOM Rajiv Kaila, MRCS, MSc, MFSEM(UK), FEBOT, UNITED KINGDOM Tom CB Pollard, MD, FRCS (Tr & Orth), UNITED KINGDOM Antonio J. M. D. Andrade, MB BS, M.Sc., FRCS(Tr&Orth), UNITED KINGDOM
Endoscopic Iliotibial Band Release During Hip Arthroscopy For Femoroacetabular Impingement Syndrome And External Snapping Hip Had Better Patient-Reported Outcomes: A Retrospective Comparative Study Abstract Presentation 5 minutes 春宝李, 医学博士，博士, CHINA Shanxing Zhang, MD, CHINA
The Relationship Between Early And Mid-Term Hip Arthroscopy Outcomes: Employing 3 Month Follow-Up To Predict Mid-Term Results Abstract Presentation 5 minutes Mario Hevesi, MD, PhD, UNITED STATES Ajay C. Lall, MD, MS, FAAOS, UNITED STATES David E. Hartigan, MD, UNITED STATES Bruce A. Levy, MD, UNITED STATES Benjamin G. Domb, MD, UNITED STATES Aaron J. Krych, MD, UNITED STATES
Covid Mortality Among Neck Of Femur Fractures During The Pandemic 2019 Abstract Presentation 5 minutes Aashish Raghu, MBBS, MS, MRCS, FRCS (Tr & Orth), UNITED KINGDOM Anas Hassan, MBBS, MRCS, UNITED KINGDOM Nicholas Dr Roeck, MB ChB, FRCS (ENG), FRCS (Tr&Orth), UNITED KINGDOM Mohamed Antar, MBBS, Master of Orthopaedics, MRCS, UNITED KINGDOM
Superior Outcomes With Routine Capsular Repair In Hip Arthroscopy Abstract Presentation 5 minutes Austin M Looney, MD, UNITED STATES Spencer M Comfort, BS, UNITED STATES Patrick T Connolly, BS, UNITED STATES Julia E McCann, MD, UNITED STATES Andrew Curley, MD, UNITED STATES William F. Postma, MD, UNITED STATES
Biomechanical Assessment of the Risk of Hip Injury During A 2,000m Ergometer Row Test Abstract Presentation 5 minutes Jordan Page Ankersen, BS, UNITED STATES Stephanie S Gardner, MD, UNITED STATES Bradley S Lambert, PhD, UNITED STATES Joshua D Harris, MD, UNITED STATES Patrick C. McCulloch, MD, UNITED STATES Michael R Moreno, PhD, UNITED STATES Shari Liberman, MD, UNITED STATES
Outcomes Of Revision Hip Arthroscopy Are Unaffected By Intraoperative Findings: A Matched Cohort Study ePoster Presentation Hari Krishna Ankem, MD, UNITED STATES Samantha Diulus, BS, UNITED STATES Cynthia Kyin, BA, UNITED STATES Jacob Shapira, MD, UNITED STATES Philip Joseph Rosinsky, MD, UNITED STATES Mitchell Meghpara, MD, UNITED STATES Ajay C. Lall, MD, MS, FAAOS, UNITED STATES Benjamin G. Domb, MD, UNITED STATES
No Association Between Intrauterine Contraceptive Devices and Musculoskeletal Hip Joint Pain Abstract Presentation 5 minutes Nathan Varady, MD, MBA, UNITED STATES Paul F Abraham, BS, UNITED STATES Michael Peter Kucharik, BS, UNITED STATES Christopher T Eberlin, BS, UNITED STATES David Freccero, MD, UNITED STATES Eric L. Smith, MD, UNITED STATES Scott D Martin, MD, UNITED STATES
Segmental Labral Reconstruction With A Polyurethane Scaffold: Assessment Of Femoro-Acetabular Contact Mechanics Abstract Presentation 5 minutes Bruno Capurro, MD, PhD., SPAIN Marc Tey Pons, MD, PhD, MScs, SPAIN Francisco Reina, MD, PhD, SPAIN Anna Carrera, MD, PhD., SPAIN Mauricio Gidi, MD, SPAIN Joan Carles Monllau, MD, PhD, Prof., SPAIN

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Effect Of Femoral And Acetabular Version On Outcomes Following Hip Arthroscopy: A Systematic Review And Meta-Analysis

Effect Of Femoral And Acetabular Version On Outcomes Following Hip Arthroscopy: A Systematic Review And Meta-Analysis

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Effect Of Femoral And Acetabular Version On Outcomes Following Hip Arthroscopy: A Systematic Review And Meta-Analysis

Effect Of Femoral And Acetabular Version On Outcomes Following Hip Arthroscopy: A Systematic Review And Meta-Analysis

Purpose

Methods

Results

Conclusion

More ISAKOS 2021: Global Content