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Concomitant Lumbar Spine Pathology in Patients Undergoing Hip Arthroscopy: A Matched Cohort Analysis

OBJECTIVES: Hip arthroscopy for femoroacetabular impingement (FAI) and related hip pathology is increasing in volume. Variable presentations of hip pain often lead to confusion with lumbar spine pathology however. We sought to define the relationship between the lumbar spine and the hip joint. Our h...

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Autores principales: Mahure, Siddharth Ashok, Ryan, Michael K., Buckland, Aaron, Hamula, Mathew, Begly, John, Capogna, Brian, Looze, Chris, Chenard, Kristofer E., Wolfson, Theodore, Youm, Thomas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5565009/
http://dx.doi.org/10.1177/2325967117S00422
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author Mahure, Siddharth Ashok
Ryan, Michael K.
Buckland, Aaron
Hamula, Mathew
Begly, John
Capogna, Brian
Looze, Chris
Chenard, Kristofer E.
Wolfson, Theodore
Youm, Thomas
author_facet Mahure, Siddharth Ashok
Ryan, Michael K.
Buckland, Aaron
Hamula, Mathew
Begly, John
Capogna, Brian
Looze, Chris
Chenard, Kristofer E.
Wolfson, Theodore
Youm, Thomas
author_sort Mahure, Siddharth Ashok
collection PubMed
description OBJECTIVES: Hip arthroscopy for femoroacetabular impingement (FAI) and related hip pathology is increasing in volume. Variable presentations of hip pain often lead to confusion with lumbar spine pathology however. We sought to define the relationship between the lumbar spine and the hip joint. Our hypothesis is that patients with concurrent lumbar spine pathology will experience inferior outcomes after hip arthroscopy when compared to patients without lumbar spine pathology. METHODS: Prospectively-collected data from a single-surgeon database from 2010 to 2014 was used to identify patients who had undergone hip arthroscopy and had documented concurrent lumbar spine pathology. Patients with spine pathology were matched by age, gender, and BMI in a 3:1 fashion to patients without spine pathology. Baseline pre-operative modified Harris Hip Scores (mHHS) were compared to scores at two-year follow-up. “Poor outcome” of initial hip arthroscopy was defined as any combination of: requiring a revision procedure, conversion to THA, or mHHS below 70. RESULTS: 167 patients met inclusion criteria: 72.5% were “normal” while 27.5% had spine pathology. Baseline demographics were appropriately matched between cohorts (Table I). Preoperative and two-year mHHS scores were significantly different between cohorts (Figure 1). Both cohorts demonstrated significant within-group improvement at two-year follow-up, however normal patients had greater improvements than those with spine pathology (34.0 vs 31.76, p<0.001). Overall revision/THA conversion rate for entire cohort was 14.97%, with nearly twice as many spine co-pathology patients requiring additional surgery than those in the normal cohort (23.91% vs 11.57%, p=0.045). Patients with spine pathology were significantly more likely to have “poor outcomes” than those without spine pathology (36.96% vs 21.49%, p=0.048). CONCLUSION: Our results demonstrate that patients undergoing hip arthroscopy with concomitant lumbar spine pathology demonstrate significantly lower total improvement, significantly higher revision/THA conversion rates and significantly higher rates of suboptimal outcomes after hip arthroscopy than patients without spine pathology.
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spelling pubmed-55650092017-08-24 Concomitant Lumbar Spine Pathology in Patients Undergoing Hip Arthroscopy: A Matched Cohort Analysis Mahure, Siddharth Ashok Ryan, Michael K. Buckland, Aaron Hamula, Mathew Begly, John Capogna, Brian Looze, Chris Chenard, Kristofer E. Wolfson, Theodore Youm, Thomas Orthop J Sports Med Article OBJECTIVES: Hip arthroscopy for femoroacetabular impingement (FAI) and related hip pathology is increasing in volume. Variable presentations of hip pain often lead to confusion with lumbar spine pathology however. We sought to define the relationship between the lumbar spine and the hip joint. Our hypothesis is that patients with concurrent lumbar spine pathology will experience inferior outcomes after hip arthroscopy when compared to patients without lumbar spine pathology. METHODS: Prospectively-collected data from a single-surgeon database from 2010 to 2014 was used to identify patients who had undergone hip arthroscopy and had documented concurrent lumbar spine pathology. Patients with spine pathology were matched by age, gender, and BMI in a 3:1 fashion to patients without spine pathology. Baseline pre-operative modified Harris Hip Scores (mHHS) were compared to scores at two-year follow-up. “Poor outcome” of initial hip arthroscopy was defined as any combination of: requiring a revision procedure, conversion to THA, or mHHS below 70. RESULTS: 167 patients met inclusion criteria: 72.5% were “normal” while 27.5% had spine pathology. Baseline demographics were appropriately matched between cohorts (Table I). Preoperative and two-year mHHS scores were significantly different between cohorts (Figure 1). Both cohorts demonstrated significant within-group improvement at two-year follow-up, however normal patients had greater improvements than those with spine pathology (34.0 vs 31.76, p<0.001). Overall revision/THA conversion rate for entire cohort was 14.97%, with nearly twice as many spine co-pathology patients requiring additional surgery than those in the normal cohort (23.91% vs 11.57%, p=0.045). Patients with spine pathology were significantly more likely to have “poor outcomes” than those without spine pathology (36.96% vs 21.49%, p=0.048). CONCLUSION: Our results demonstrate that patients undergoing hip arthroscopy with concomitant lumbar spine pathology demonstrate significantly lower total improvement, significantly higher revision/THA conversion rates and significantly higher rates of suboptimal outcomes after hip arthroscopy than patients without spine pathology. SAGE Publications 2017-07-31 /pmc/articles/PMC5565009/ http://dx.doi.org/10.1177/2325967117S00422 Text en © The Author(s) 2017 http://creativecommons.org/licenses/by-nc-nd/3.0/ This open-access article is published and distributed under the Creative Commons Attribution - NonCommercial - No Derivatives License (http://creativecommons.org/licenses/by-nc-nd/3.0/), which permits the noncommercial use, distribution, and reproduction of the article in any medium, provided the original author and source are credited. You may not alter, transform, or build upon this article without the permission of the Author(s). For reprints and permission queries, please visit SAGE’s Web site at http://www.sagepub.com/journalsPermissions.nav.
spellingShingle Article
Mahure, Siddharth Ashok
Ryan, Michael K.
Buckland, Aaron
Hamula, Mathew
Begly, John
Capogna, Brian
Looze, Chris
Chenard, Kristofer E.
Wolfson, Theodore
Youm, Thomas
Concomitant Lumbar Spine Pathology in Patients Undergoing Hip Arthroscopy: A Matched Cohort Analysis
title Concomitant Lumbar Spine Pathology in Patients Undergoing Hip Arthroscopy: A Matched Cohort Analysis
title_full Concomitant Lumbar Spine Pathology in Patients Undergoing Hip Arthroscopy: A Matched Cohort Analysis
title_fullStr Concomitant Lumbar Spine Pathology in Patients Undergoing Hip Arthroscopy: A Matched Cohort Analysis
title_full_unstemmed Concomitant Lumbar Spine Pathology in Patients Undergoing Hip Arthroscopy: A Matched Cohort Analysis
title_short Concomitant Lumbar Spine Pathology in Patients Undergoing Hip Arthroscopy: A Matched Cohort Analysis
title_sort concomitant lumbar spine pathology in patients undergoing hip arthroscopy: a matched cohort analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5565009/
http://dx.doi.org/10.1177/2325967117S00422
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