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Published on: January 21, 2009
Femoral head infarction: a case-control study of a rare complication
Guanying Gao1, Rongge Liu1, Yichuan Zhu1
1Department of Sports Medicine, Institute of Sports Medicine, Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China.
Background:
To determine the prevalence of the femoral head infarction (FHI) following hip arthroscopy, explore potential contributing factors, and assess its influence on clinical outcomes.
Methods:
We evaluated consecutive patients who underwent hip arthroscopy in our hospital between May 2014 and May 2023 retrospectively. Patients underwent MRI at least one year after surgery. FHI was identified as large scale edema signal at the junction of the femoral head and neck in postoperative MRI. FHI were matched in a 1:3 cohort to the normal group based on sex, age, and body mass index (BMI). Preoperative patient-reported outcomes (PROs) and PROs at least one year after surgery were obtained.
Results:
A total of 372 patients were finally included in this study. In the MRI follow-up, it was discovered that ten patients (2.7%) had FHI. Patients in FHI group had significantly lower BMI than patients without FHI (P = 0.008). Patients in the FHI group did not show significant improvements in postoperative mHHS, iHOT-12, or VAS scores (P > 0.05). Patients in the FHI group demonstrated significantly lower postoperative mHHS and iHOT-12 scores, along with higher VAS scores (P < 0.05). In the FHI group, only 3 patients (30%) surpassed the MCID and achieved the PASS for mHHS, while no patients surpassed the MCID or achieved the PASS for iHOT-12. The proportion of patients who achieved the MCID or the PASS in the normal group was significantly higher than that in the FHI group (P < 0.05).
Conclusion:
Our study demonstrated that FHI could be a rare complication following hip arthroscopy. Patients with lower BMI are at a higher risk of developing postoperative FHI. The clinical outcomes for patients with FHI are poor, with no significant improvement in patient-reported outcomes observed.
Insights
Femoral head infarction (FHI) is a rare complication after hip arthroscopy, affecting 2.7% of patients. Lower BMI increases FHI risk, leading to poor clinical outcomes and no significant improvement in patient-reported scores.
Area of Science:
- Orthopedic Surgery
- Radiology
- Patient Outcomes
Background:
- Hip arthroscopy is a common procedure for hip joint issues.
- Femoral head infarction (FHI) is a potential complication following hip arthroscopy.
- Understanding FHI prevalence and impact is crucial for patient care.
Purpose of the Study:
- Determine the prevalence of femoral head infarction (FHI) after hip arthroscopy.
- Identify factors contributing to FHI development.
- Assess the impact of FHI on clinical outcomes.
Main Methods:
- Retrospective evaluation of 372 patients undergoing hip arthroscopy (May 2014-May 2023).
- Postoperative MRI at least one year after surgery to identify FHI.
- Matched cohort analysis comparing FHI patients with a normal group based on sex, age, and BMI.
- Preoperative and postoperative patient-reported outcomes (PROs) collected.
Main Results:
- FHI was identified in 10 patients (2.7%).
- Lower BMI was significantly associated with FHI development (P=0.008).
- FHI patients showed poorer postoperative outcomes (mHHS, iHOT-12, VAS) compared to the normal group, with significantly fewer achieving minimal clinically important difference (MCID) or patient-acceptable symptom state (PASS).
Conclusions:
- Femoral head infarction (FHI) is a rare but significant complication of hip arthroscopy.
- Lower body mass index (BMI) is a risk factor for developing FHI post-surgery.
- FHI is associated with poor clinical outcomes and limited patient-reported improvement.
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