The American journal of sports medicine
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Osteochondral allograft (OCA) transplant for symptomatic focal cartilage defects in the knee has demonstrated favorable short- to midterm outcomes. However, the reoperation rate is high, and literature on mid- to long-term outcomes is limited. ⋯ OCA transplant was associated with significant clinical improvement and durability at mid- to long-term follow-up, with 5- and 10-year survival rates of 86.2% and 81.8%, respectively. Maintenance of CSOs can be expected in the majority of patients at a mean of 7.7 years after OCA transplant. Although the reoperation rate was high (39.4%) and could have adversely affected chances of maintaining MCID, most patients did not have failure at long-term follow-up.
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Improvement in patient-reported outcomes (PROs) has been reported in the short term after hip arthroscopy for femoroacetabular impingement syndrome (FAIS) and labral tear in the setting of acetabular overcoverage. Yet, there is a paucity of information in the literature on midterm PROs. ⋯ In the context of FAIS, labral tears, and acetabular overcoverage, patients who underwent hip arthroscopy reported significant improvement in several PROs at minimum 5-year follow-up. Moreover, outcomes were comparable with those of a propensity-matched control group without acetabular overcoverage. Furthermore, the rate of achieving the MCID for the mHHS, HOS-SSS, and NAHS was similar between these groups.
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The treatment of pincer deformity in hip arthroscopy remains controversial, with some authors advocating that over resection may risk early joint deterioration. The role of acetabular resection depth and postoperative acetabular morphology on postoperative outcomes has yet to be defined. ⋯ Patients with postoperative LCEA values outside the normal reference range and with large resections perform similar to those with normal postoperative LCEA values and smaller resections at a minimum 5-year follow-up.
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Significant short-term improvements in function and pain after arthroscopic management of femoroacetabular impingement syndrome (FAIS) have been demonstrated regardless of mass index (BMI). No studies have reported the influence of obesity on mid- to long-term outcomes. ⋯ There were significant improvements in at least 1 outcome score across all BMI groups with arthroscopic treatment of FAIS. While the normal weight patients demonstrated universal improvement in all patient-reported outcomes and significantly greater likelihood of achieving PASS and SCB, the higher BMI groups still demonstrated significant improvement in function and pain, except for the morbidly obese group. Patients with morbid obesity demonstrated long-term pain improvement, although they did not experience functional improvement.
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Hip arthroscopy in patients with borderline dysplasia continues to be surrounded by controversy. Even more controversial is the management of the failed hip arthroscopy in this population. There is a paucity of studies in contemporary literature regarding outcomes after arthroscopic revision surgery. ⋯ After revision hip arthroscopy, significant improvement was obtained for all PROs in patients with borderline dysplasia at a minimum 2-year follow-up. Moreover, outcomes, patient satisfaction, the rate for achieving the MCID for the mHHS and VAS, and the rate for secondary surgery were similar to those of a propensity-matched control group without dysplasia. Nevertheless, there was a nonsignificant trend toward higher secondary procedures in the study group; therefore, arthroscopic revision surgery in the borderline patients should be approached with measured prognosis.