Preoperative Paralabral Cysts Predict More Significant Chondral Damage but Not 2-Year Functional Outcomes Following Arthroscopic Labral Repair.

Autor:	Dean MC; Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts, U.S.A.. Electronic address: michael.c.dean3@gmail.com., Cherian NJ; Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts, U.S.A.; Department of Orthopaedic Surgery, University of Nebraska, Omaha, Nebraska, U.S.A., McBroom TJ; Harvard Medical School, Boston, Massachusetts, U.S.A., Eberlin CT; Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts, U.S.A.; Department of Orthopaedic Surgery, University of Iowa, Iowa City, Iowa, U.S.A., Torabian KA; Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts, U.S.A., Dowley KS; Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts, U.S.A., LaPorte ZL; Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts, U.S.A., Kucharik MP; Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts, U.S.A., Martin SD; Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts, U.S.A.; Harvard Medical School, Boston, Massachusetts, U.S.A.
Jazyk:	angličtina
Zdroj:	Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association [Arthroscopy] 2024 May; Vol. 40 (5), pp. 1475-1487.e1. Date of Electronic Publication: 2023 Oct 20.
DOI:	10.1016/j.arthro.2023.10.009
Abstrakt:	Purpose: To investigate whether paralabral cysts identified incidentally on preoperative magnetic resonance imaging/arthrography predict 2-year functional outcomes after arthroscopic acetabular labral repair. Methods: Prospectively collected data for patients undergoing primary hip arthroscopy by a single surgeon from 2014 to 2020 were retrospectively reviewed. Included patients were ≥18 years and completed baseline patient-reported outcome measures (PROMs) with additional follow-up at 3, 6, 12, and 24 months. Exclusion criteria were labral debridement, hip dysplasia, advanced hip osteoarthritis (Tönnis > 1), or previous ipsilateral hip surgery. Patients were stratified based on the presence of paralabral cysts identified on magnetic resonance imaging/arthrography. Primary outcomes were International Hip Outcome Tool and modified Harris Hip Score. Secondary outcomes included other PROMs and the visual analog pain scale. Outcomes were compared between cohorts using linear mixed-effects models and Fisher's exact tests. Sensitivity analyses accounted for preoperative PROMs, nonlinear improvement trajectories, and relevant baseline characteristics. Results: Of the 182 included hips (47.8% female; mean ± standard deviation age, 36.9 ± 11.4), 30 (16.4%) had paralabral cysts. During the 2-year study period, there were no significant differences between patients with and without paralabral cysts in terms of International Hip Outcome Tool scores (weighted difference = 1.60; 95% confidence interval [CI], -5.09, 8.28; P = .64), modified Harris Hip Scores (weighted difference = 0.56; 95% CI, -4.16, 5.28; P = .82), or any secondary outcomes (except for HOS-Sports Subscale at 3 months [mean difference = -11.85; 95% CI, -22.85, -0.84; P = .035]). Furthermore, there were no significant differences in clinically meaningful outcomes (P > .05 for all), revision rates (P > .99), or conversion to total hip arthroplasty between cohorts (P > .99). These results held across all sensitivity analyses. Conclusions: Although preoperative paralabral cysts were associated with worse cam impingement and more severe chondral damage observed intraoperatively, they did not predict 2-year functional outcomes or clinically meaningful improvements, suggesting that incidentally discovered paralabral cysts are not a contraindication for arthroscopic labral repair. Level of Evidence: Level III, retrospective cohort study. (Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu