Summary: Patients who received BMAC during arthroscopic labral repair reported significantly less pain than those who did not receive BMAC. Patients receiving BMAC also reported with minimal complications.

Introduction

The purpose of this study was to compare pain levels and medication use in the perioperative period in patients undergoing arthroscopic labral repair with and without BMAC application. The secondary purpose of this study was to report safety of the procedure by evaluating post-operative complications from the perioperative period to final follow-up.

Methods

A prospective cohort of consecutive patients undergoing arthroscopic acetabular labral repair with possible BMAC application between January 2018 and March 2020 were offered enrollment into the study. BMAC was not used in patients with widespread degenerative changes or patients without any discernable degenerative changes. Each patient was prescribed 20 tablets of 5 mg oxycodone and was instructed to take 1 tablet for breakthrough pain of moderate intensity. Patients were instructed to complete a medication and visual analog scale (VAS) pain tracker and return it at their suture removal appointment, approximately 12-14 days after surgery. Outcomes collected from this tracker were compared between the group of patients treated with BMAC and the group not treated with BMAC. In addition, retrospective chart review was conducted for 171 patients who received BMAC by the senior surgeon during arthroscopic acetabular labral repair. Progress notes from the perioperative period until final follow-up were examined for possible complications related to BMAC harvesting and application.

Results

Seventy patients [40 (57.1%) males] completed the medication and pain tracker. 59 (84.3%) of these patients underwent BMAC application. Mean (95% CI) age was 31.71 (29.52, 33.91). On postoperative day #1 (POD#1), VAS pain scores were lower in the BMAC group, approaching statistical significance (4.76 vs. 6.18 p=0.095). The BMAC group reported significantly less pain than the No BMAC group on POD#5 (3.53 vs. 5.18; p=0.010), POD #10 (2.23 vs. 3.73; p=0.014), and the suture removal appointment (1.80 vs. 3.18; p=0.008). The mean length of opioid (4.02 vs. 2.82 days; p=0.348) and NSAID (8.59 vs. 8.00 days; p=0.677) usage did not differ significantly between groups. The total number of opioid (8.47 vs. 7.45; p=0.715) and NSAID (27.83 vs. 21.36; p=0.464) pills taken also did not differ significantly between groups. The maximum number of opioid (2.61 vs. 2.64; p=0.973) and NSAID (5.07 vs. 5.55; p=0.708) pills taken in a single day was also similar. Among the 171 patients in the retrospective cohort, 19 (11.1%) had signs of heterotopic ossification (HO) on follow-up radiograph, 2 (1.2%) progressed to total hip arthroplasty (THA) by final follow-up, and 1 (0.5%) had evidence of neuropraxia. Zero patients had evidence of wound infection, joint infection, skin necrosis, hemorrhage, avascular necrosis, or required a repeat arthroscopic procedure.

Discussion

Patients treated with BMAC at the time of hip arthroscopy had significantly lower VAS pain scores than those not treated with BMAC, despite undergoing bone marrow aspiration—normally a painful procedure. Furthermore, the patients treated with BMAC used opioids and NSAID medications at similar rates as those treated without BMAC. Patients treated with BMAC suffered minimal postoperative complications, as zero patients had evidence of joint infection, wound infection, or hemorrhage secondary to BMAC harvesting and application.

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Arthroscopic Tendon Release for Iliopsoas Impingement after Total Hip Arthroplasty ePoster Presentation Michael Andreas Finsterwald, MD, AUSTRALIA Georgina Waters, MD, AUSTRALIA Jay R. Ebert, PhD, AUSTRALIA Christopher W. Jones, FAOrthA FRACS PhD MBBS(Hons) BEng(Hons) BCom, AUSTRALIA Piers Yates, MBBS(Hons) BSc(Hons) MRCS(Eng) FRCS(Tr & Orth) FRA, AUSTRALIA Peter Alberto D'Alessandro, MBBS Hons. (UWA) FRACS FAOrthA, AUSTRALIA
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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
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
Predicting Dissatisfaction Following Total Hip Arthroplasty Using A Bayesian Model Averaging (Bma) Approach: Results From The Australian Arthroplasty Clinical Outcomes Registry (Acorn) ePoster Presentation Jan Peter Van Meirhaeghe, MD, BELGIUM Rob Molnar, MBBS, AUSTRALIA Sam Adie, BSc(Med) MBBS MSpMed MPH PhD FRACS, AUSTRALIA
Persistent Post-Operative Opioid Use Following Hip Arthroscopy Is Common And Is Associated With Pre-Operative Opioid Use And Age ePoster Presentation Ryan M. Degen, MD, FRCSC, CANADA J. Andrew McClure, MSc, CANADA Britney Le, MSc, CANADA Blayne Welk, MD, CANADA Jacquelyn Marsh, PhD, CANADA
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 J Nho, MD, MS, UNITED STATES
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
Stem Cells Injection And Percutaneous Femoral Head Decompression - An Extremely Rare Procedure With Good Results ePoster Presentation Sofia Moura De Carvalho, MD, PORTUGAL Inês Domingues, MD, PORTUGAL Liliana Domingues, MD, PORTUGAL Eduardo Ramalho Silva, MD, PORTUGAL Gonçalo Lavareda, MD, PORTUGAL Filipe Machado, MD, PORTUGAL Rita Ricardo, MD, PORTUGAL
Clinical Predictors of Outcome Following Proximal Hamstring Tendon Repair ePoster Presentation Heath Patrick Gould, MD, UNITED STATES William Rate, MS, MD, UNITED STATES Matthew Civilette, MD, UNITED STATES John Hamilton, MD, UNITED STATES James Dreese, 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
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 Associated Both Column Acetabular Fractures with and without a Posterior Wall Fracture ePoster Presentation George Bradley Reahl, MS, UNITED STATES Michael McTague, MPH, UNITED STATES Nishant Suneja, MD, UNITED STATES Arvind Von Keudell, MD, UNITED STATES
What is the Association Between Anterior Cruciate Ligament Reconstruction and Femoroacetabular Impingement Surgery? An Analysis of Over 18,000 Hip Arthroscopies Abstract Presentation 6 minutes Clare Wise, BS , UNITED STATES Marc R. Safran, MD, Prof., UNITED STATES Jeremy N. Truntzer, MD, UNITED STATES Robin Kamal, MD, MBA , UNITED STATES
The Effect Of Osteochondroplasty On Time To Reoperation After Arthroscopic Management Of Femoroacetabular Impingement Abstract Presentation 5 minutes Jeffrey Kay, MD, CANADA Nicole Simunovic, MSc, CANADA Olufemi R. Ayeni, MD, PhD, MSc, FRCSC, CANADA FIRST Investigators, MD, CANADA
“X-Square” Technique For Radial Meniscal Root Tear ePoster Presentation Winyou Ratanachai, MD.M Ch(Orth)., THAILAND Keerati Klinchanhom, MD, THAILAND
Capsular Complications And Subsequent Instability On The Rise As Indications For Revision Hip Arthroscopy ePoster Presentation Ryan S. Selley, MD, UNITED STATES Molly A Day, MD, UNITED STATES Reena Olsen, BS, UNITED STATES Cort D. Lawton, MD, UNITED STATES Matthew S. Dooley, MA, UNITED STATES Stephanie S Buza, MD, UNITED STATES Bryan T. Kelly, MD, UNITED STATES Anil S. Ranawat, MD, UNITED STATES Danyal H. Nawabi, MD, FRCS(Orth), UNITED STATES
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

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Can BMAC Application Safely Diminish Perioperative Pain In Patients Undergoing Hip Arthroscopy?

Can BMAC Application Safely Diminish Perioperative Pain In Patients Undergoing Hip Arthroscopy?

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Discussion

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Can BMAC Application Safely Diminish Perioperative Pain In Patients Undergoing Hip Arthroscopy?

Can BMAC Application Safely Diminish Perioperative Pain In Patients Undergoing Hip Arthroscopy?

Introduction

Methods

Results

Discussion

More ISAKOS 2021: Global Content