Journal article
The Impact of Age on Clinical Outcomes of Acetabular Microfracture During FAI Surgery
The American journal of sports medicine, Vol.51(10), pp.2559-2566
08/2023
DOI: 10.1177/03635465231184398
PMID: 37470491
Abstract
BACKGROUND Full-thickness acetabular cartilage lesions are common findings during primary surgical treatment of femoroacetabular impingement (FAI). PURPOSE To evaluate clinical outcomes after acetabular microfracture performed during FAI surgery in a prospective, multicenter cohort. STUDY DESIGN Cohort Study; Level of evidence, 3. METHODS Patients with FAI who had failed nonoperative management were prospectively enrolled in a multicenter cohort. Preoperative and postoperative (mean follow-up, 4.3 years) patient-reported outcome measures were obtained with a follow-up rate of 81.6% (621/761 hips), including 54 patients who underwent acetabular microfracture. Patient characteristics, radiographic parameters, intraoperative disease severity, and operative procedures were analyzed. Propensity matching using linear regression was used to match 54 hips with microfracture to 162 control hips (1:3) to control for confounding variables. Subanalyses of hips ≤35 and >35 years of age with propensity matching were also performed. RESULTSPatients who underwent acetabular microfracture were more likely to be male (81.8% vs 40.9%; P < .001), be older in age (35.0 vs 29.9 years; P = .001), have a higher body mass index (27.2 vs 25.0; P = .001), and have a greater alpha angle (69.6° vs 62.3°; P < .001) compared with the nonmicrofracture cohort (n = 533). After propensity matching to control for covariates, patients treated with microfracture displayed no differences in the modified Harris Hip Score or Hip Disability and Osteoarthritis Outcome Score (P = .22-.95) but were more likely to undergo total hip arthroplasty (THA) (13% [7/54] compared with 4% [6/162] in the control group; P = .002), and age >35 years was associated with conversion to THA after microfracture. Microfracture performed at or before 35 years of age portended good outcomes with no significant risk of conversion to THA at the most recent follow-up. CONCLUSION Microfracture of acetabular cartilage defects appears to be safe and associated with reliably improved short- to mid-term results in younger patients; modified expectations should be realized when full-thickness chondral lesions are identified in patients >35 years of age.
Details
- Title: Subtitle
- The Impact of Age on Clinical Outcomes of Acetabular Microfracture During FAI Surgery
- Creators
- Robert W WestermannJeffrey J NeppleCecilia Pascual-GarridoChristopher M LarsonIra ZaltzPaul E BeauléYoung-Jo KimMichael MillisDaniel J SucatoErnest L SinkRafael J SierraDavid A PodeszwaWudbhav N SankarAsheesh BediTravis H MatheneyEduardo N NovaisEtienne L BelzileJohn C Clohisy
- Resource Type
- Journal article
- Publication Details
- The American journal of sports medicine, Vol.51(10), pp.2559-2566
- DOI
- 10.1177/03635465231184398
- PMID
- 37470491
- ISSN
- 0363-5465
- eISSN
- 1552-3365
- Grant note
- DOI: 10.13039/100012630, name: zimmer biomet, award: #CW107745; Hips
- Language
- English
- Electronic publication date
- 07/20/2023
- Date published
- 08/2023
- Academic Unit
- Orthopedics and Rehabilitation; Athletic Training Program
- Record Identifier
- 9984445622402771
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