Clinical and Radiographic Predictors for Worsened Clinical Outcomes After Hip Arthroscopic Labral Preservation and Capsular Closure in XXXX .

@entity1 @entity572 @entity571
BACKGROUND: @entity1 with @entity572 ( @entity572 ) have a greater risk of acetabular labral tearing and joint instability, which predispose them to developing @entity571 . The arthroscopic management of @entity572 , however, remains controversial. HYPOTHESIS: Specific clinical characteristics and radiographic parameters correlate with and predict a worsened clinical outcome after hip arthroscopic surgery for @entity572 . STUDY DESIGN: Case control study; Level of evidence, 3. METHODS: Of @entity1 with @entity572 who underwent an arthroscopic procedure between March 2009 and June 2011, there were 28 hips in 28 @entity1 (6 male and 22 female) that met the inclusion criteria. The mean @entity1 age was 28.4 years. Clinical and radiographic follow-up evaluations up to a minimum of 2 years after surgery were performed for all @entity1 . Failure of the procedure was defined as conversion to subsequent surgery or having a T  nnis @entity571 grade of 2 and modified Harris Hip Score (mHHS) that remained <85, and success was defined as @entity1 who did not need subsequent surgery and had an mHHS >85. Univariate analysis and Cox hazard proportional analysis were performed on the 2 subpopulations. RESULTS: There were 9 @entity1 in the failure group (including 3 hips with T nnis grade 2) and 19 @entity1 in the success group. In 22 of 28 @entity1 , the mean mHHS significantly improved from 61.6    18.8 (range, 12.0-85.0) preoperatively to 94.3    7.0 (range, 73.7-100.0) at final follow-up, and the mean Non-Arthritic Hip Score (NAHS) improved from 56.2    13.9 (range, 35.0-81.3) preoperatively to 92.7    9.5 (range, 65.0-100.0) at final follow-up (P < .001, Wilcoxon signed-rank test). Univariate analysis showed that a broken Shenton line was significantly more prevalent in the failure group compared with the success group (8/9 [89%] vs 3/19 [16%] @entity1 , respectively; P < .001). High-grade cartilage delamination (Multicenter Arthroscopy of the Hip Outcomes Research Network [MAHORN] grades 3-5) was significantly higher in the failure group than in the success group (8/9 [89%] vs 3/19 [16%] @entity1 , respectively; P < .001). The median femoral neck-shaft (FNS) angle in the failure group was significantly higher than that in the success group (139   vs 134  , respectively; P = .01). Further, Cox hazard proportional analysis of the failure group showed that the predictors for a poor clinical outcome were the presence of a broken Shenton line, FNS angle >140  , center-edge (CE) angle <19  , body mass index (BMI) >23 kg/m(2), acetabular cartilage damage (MAHORN grades 3-5), and cartilage damage of the femoral head (International Cartilage Repair Society grades 2-4). The most important predictors for a poor clinical outcome at the time of surgery were a broken Shenton line and an FNS angle >140  . CONCLUSION: @entity1 with a broken Shenton line, FNS angle >140  , CE angle <19  , or BMI >23 kg/m(2) at the time of surgery are not good candidates for the arthroscopic management of @entity572 .
