Positive predictors of hip mosaicplasty outcomes: a systematic review and meta-analysis with knee comparison

Osteochondral defects of the hip, resulting from avascular necrosis (AVN), trauma, and femoroacetabular impingement (FAI), are challenging in management. While osteochondral autograft transplantation (OAT) has shown promising outcomes in the knee and ankle, its application in the hip is not well understood. The goal of this paper is to explore the positive predictor factors for significant increases in the Harris Hip Score (HHS) in post-operative patients.

A systematic review and meta-analysis were performed using PubMed, CINAHL, SCOPUS, Embase, and Cochrane Central Register of Controlled Trials databases, including studies reporting pre- and post-operative HHS for hip OAT. The quality of the methodologies of this study was evaluated using the Modified Coleman Methodology Scores (MCMS). Random-effects meta-analyses explored outcome variations based on gender, follow-up duration, age, defect size, etiology, site of defect, surgical approach, and presence of complications.

Analysis of eleven studies (70 patients), revealed a mean HHS improvement of 32.43 points post-operatively. Superior results were associated with ipsilateral knee donor cartilage and absence of complications. The increase in score did not significantly change based on the average length of follow-up, age of participants, etiology of disease, size of the defect, or type of surgery. The mean MCMS was 44.32±12.70, which is considered poor.

Due to the small number of papers focusing on mosaicplasty in the hip, the positive predictor correlations found in the knee are not readily identified in the hip. It is important to gather larger-scale studies to effectively evaluate the outcomes of hip OAT procedures on the functional outcomes of patients. The current literature we have is an introduction to the potential this procedure holds for patients.