title: Intraoperative cartilage degeneration predicts outcome 12 months after hip arthroscopy.
abstract: BACKGROUND
  When considering arthroscopic surgery for treatment of hip pain, it is important to understand the influence of joint degeneration on the likelihood of success. Previous research has shown poorer outcomes among patients with osteoarthritis but new arthroscopic techniques including femoroacetabular impingement correction and microfracture may lead to better arthroscopic outcomes.
  
  
  OBJECTIVE
  We investigated the effect of intraarthroscopic articular and rim cartilage degeneration on the outcome after hip arthroscopy using contemporary techniques.
  
  
  METHODS
  The modified Harris hip score (MHHS) and nonarthritic hip score (NAHS) were completed preoperatively and 12 months postoperatively by 560 patients undergoing hip arthroscopy after March 2007. Change in these scores was compared between patients with and without acetabular or femoral articular cartilage degeneration and between patients with and without rim cartilage degeneration. Correlation and regression analyses were used to predict the change in outcome scores based on the severity of cartilage degeneration.
  
  
  RESULTS
  Hips without degeneration had greater improvement in the outcome scores. The presence of cartilage degeneration showed negative correlations with change in outcomes. The best model to explain change in MHHS included preoperative score, articular cartilage degeneration grade, and rim lesion grade (adjusted R(2) = 0.24).
  
  
  CONCLUSIONS
  Our data support previous findings regarding the negative influence of cartilage degeneration on improvement after hip arthroscopy. Nevertheless, many patients with cartilage degeneration still improved and the severity of degeneration accounts for little of the resulting variance in change. Future studies must determine the clinical importance of the improvements gained by patients with cartilage degeneration and identify other predictors of outcome.
  
  
  METHODS
  Level III, prognostic study. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: Centre for Health Exercise & Sports Medicine, The University of Melbourne, Carlton, VIC, Australia. thor@sutmap.com
authors.forename: Thorlene
authors.initials: T
authors.lastname: Egerton
authors.forename: Rana S
authors.initials: RS
authors.lastname: Hinman
authors.forename: Amir
authors.initials: A
authors.lastname: Takla
authors.forename: Kim L
authors.initials: KL
authors.lastname: Bennell
authors.forename: John
authors.initials: J
authors.lastname: O'Donnell
mesh_terms: D000328:Adult; D000368:Aged; D001182:Arthroscopy / Q000379:methods*; D002358:Cartilage, Articular / Q000473:pathology* / Q000601:surgery; D005260:Female; D006621:Hip Joint / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000473:pathology / Q000601:surgery*; D011237:Predictive Value of Tests; D011379:Prognosis; D020127:Recovery of Function; D012189:Retrospective Studies; D016896:Treatment Outcome