Summary: Labral preserving hip arthroscopy with bone marrow aspirate injection results in statistically and clinically significant improvement in patient-reported outcomes scores for patients with symptomatic labral tears and early radiographic degenerative changes at short term follow-up.

Purpose

The treatment of labral tears of the hip in the setting of early radiographic degenerative changes is challenging, with multiple studies showing higher failure rates in this group. This study aims to define the clinical effect of intraarticular injection of iliac crest-derived bone marrow aspirate concentrate (BMAC) at the time of labral-preserving hip arthroscopy in patients with symptomatic labral tears and early radiographic degenerative changes.

Methods

A retrospective review of a prospectively collected hip registry database was performed. Patients with a symptomatic labral tear, Tönnis grade 1-2 degenerative changes who underwent labral-preserving hip arthroscopy and BMAC were included and were age- and sex-matched to patients without arthritis who underwent hip arthroscopy without BMAC. Demographic information, patient-reported outcomes measures (PROMs), procedures performed, and failure were evaluated. PROMs collected preoperatively and 6-months, 1-year, and 2-years postoperatively included Modified Harris Hip Score (mHHS), Hip Outcomes Score Activities of Daily Living (HOS ADL), Hip Outcomes Score Sport (HOS Sport), International Hip Outcomes Tool 33 (iHOT-33).

Results

35 patients underwent labral-preserving hip arthroscopy with BMAC and were matched with 35 control patients without arthritis. There was no difference in the mean age at time of surgery (p=0.75), gender (p=0.66) or BMI (p=0.10) of the BMAC group (48.5 ± 11.6 years; 68.6% female; 25.3 + 4.1 kg/m2) compared to the control group (47.9 ± 11.4 years; 68.6% female; 23.1 ± 5.3 kg/m2). The BMAC group was comprised of 31 patients (86.6%) Tönnis grade 1 and 4 (11.4%) grade 2, whereas 35 (100.0%) were Tönnis grade 0 in the controls. All outcomes scores were significantly improved for both groups at 2 years; there was no difference in improvement between the study groups. Failure requiring conversion to total hip arthroplasty was 5/35 (14.3%) at mean 1.6 years and 1/35 (5.7%) at mean 7 years postoperative in the biologic and control groups, respectively (p=0.09).

Conclusions

Labral preserving hip arthroscopy with bone marrow aspirate injection results in statistically and clinically significant improvement in patient-reported outcomes scores for patients with symptomatic labral tears and early radiographic degenerative changes at short term follow-up. Although the proportion of failures requiring total hip arthroplasty is comparable in both groups, the time to conversion is earlier in the BMAC group.
Level of Evidence: Level IV

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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
Mortality After Hip Or Knee Arthroplasty For Osteoarthritis In Chile ePoster Presentation Maximiliano Andres Barahona, MD, MSc, CHILE Cristian Barrientos, MD, CHILE Alvaro Martinez, MD, CHILE Julian Brañes, MD, CHILE Juan Pablo Prieto, MD, CHILE Jaime Hinzpeter, MD, CHILE
Hip Disorders in Bull Riders: Clinical Observations and Outcomes of Arthroscopy Abstract Presentation 6 minutes J.W. Thomas Byrd, MD, UNITED STATES Kay S. Jones, MSN, RN, UNITED STATES
Cannabis Use Is Not Associated With Increased Opioid Use Or Costs After Hip Arthroscopy Abstract Presentation 5 minutes Christopher L. McCrum, MD, UNITED STATES Jacob Thomas Wood, BS, UNITED STATES Senthil Sambandam, MD, UNITED STATES
Efficacy Of Tranexamic Acid In Hip Fracture Surgeries ePoster Presentation Aabid Sanaullah, MBBS,MRCS,MRCPS,PGDipTrauma Surg.FEBOT,FRCSTr&Orth, UNITED KINGDOM Adeel Nawab Ditta, MBBS, MRCS, UNITED KINGDOM Olufunso Damilare Onayemi, MRCS MCH (Ortho), UNITED KINGDOM Ahsan Sheeraz, BSc MBBS MRCS, UNITED KINGDOM Atif A. Malik, MB ChB, MRCS Ed, MSc. (Orto. Eng), FRCS Tr & Orth, UNITED KINGDOM
Outcomes of Proximal Hamstring Tendon Repair in Patients Older than 50 Years of Age Abstract Presentation 5 minutes Alexander Rainer Manuel Bitzer, MD, UNITED STATES Daniel Hurwit, UNITED STATES Julian Joseph Sonnenfeld, MD, UNITED STATES Durham Weeks, MD, UNITED STATES
Surgical Treatment of High-Grade Acute Intramuscular Hamstring Tendon Injuries in Athletes ePoster Presentation Randeep Singh Aujla, MBChB ChM FRCS (Tr&Orth) MFSEM, UNITED KINGDOM Steven Cecchi, BSc (Hons), MBBS, AUSTRALIA Peter Alberto D'Alessandro, MBBS Hons. (UWA) FRACS FAOrthA, AUSTRALIA Peter T. Annear, FRACS(Orth), AUSTRALIA
Arthroscopy For Gunshot Wounds To The Hip ePoster Presentation Jorge Figueras, BS, UNITED STATES J P Ertl, MD, UNITED STATES Karchi Ertl, BS, UNITED STATES Brian Mullis, MD
The Radiographical Influence Of Torsional Deformity Of The Acetabular And Femur In Dysplastic Hips ePoster Presentation Carsten Heimer, BA, GERMANY Carsten Perka, MD, PhD, GERMANY Henrik Baecker, MD, GERMANY
Not Every Hip Impingement Requires Hip Arthroscopy. 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
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
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
Sex- And Age-Based Differences In Outcomes And Survivorship Following Primary Hip Arthroscopy At Short And Mid-Term Follow-Up: A Comparative Analysis ePoster Presentation David R. Maldonado, MD, UNITED STATES Jade S Owens, BS, UNITED STATES Cammille Go, BA, UNITED STATES Benjamin G. Domb, MD, UNITED STATES
Amniotic Suspension Allograft Injection For Hip Osteoarthritis: Prospective Pilot Study With 1 Year Follow Up Abstract Presentation 5 minutes Marc R. Safran, MD, Prof., UNITED STATES Molly Claire Meadows, MD, UNITED STATES Katia Elisman, BS, UNITED STATES Shane Nho, MD, MS, UNITED STATES

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Labral Preserving Hip Arthroscopy and Bone Marrow Aspirate Injection for Patients with Symptomatic Labral Tears and Early Degenerative Changes

Labral Preserving Hip Arthroscopy and Bone Marrow Aspirate Injection for Patients with Symptomatic Labral Tears and Early Degenerative Changes

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Labral Preserving Hip Arthroscopy and Bone Marrow Aspirate Injection for Patients with Symptomatic Labral Tears and Early Degenerative Changes

Labral Preserving Hip Arthroscopy and Bone Marrow Aspirate Injection for Patients with Symptomatic Labral Tears and Early Degenerative Changes

Purpose

Methods

Results

Conclusions

More ISAKOS 2021: Global Content