Corrigendum to “Is Hip Arthroscopy an Adequate Therapy for the Borderline Dysplastic Hip? Correlation Between Radiologic Findings and Clinical Outcomes”

Objectives: The borderline dysplastic hip (characterized by a lateral centre-edge angle (LCEA): 20 - 25° and an acetabular index (AI): 10 - 15°) can pose a significant challenge as symptoms may be due to insufficient acetabular coverage, the presence of femoro-acetabular impingement (FAI) or both. Accordingly, different treatment options have been described, including peri-acetabular osteotomy (PAO), hip arthroscopy, open arthrotomy or a combination of procedures. This study aims to determine patient and deformity-specific characteristics that direct treatment decision-making in the borderline dysplastic hip. Furthermore, we describe the early-term results of both the PAO and hip arthroscopy in treating this challenging patient population. Methods: A prospective, multicenter, longitudinal surgical cohort of young adult hips was searched. From 2060 hips, 291 hips satisfied the inclusion criteria of idiopathic borderline dysplasia, adequate follow-up (> 1-year) and functional outcome. Demographic and radiographic features are included in Table 1. Fifty-five hips (19%) had a previous hip operation (most commonly a hip arthroscopy). A number of different procedure types were performed which were broadly divided into 3 groups; PAO-only (n=42), hip arthroscopy-only (n=127) or PAO and intra-articular treatment (either arthroscopically or open, addressing the cam morphology and/or labral pathology) (n=122). Outcome measures included complications-, re-operations- rates and clinical outcomes using the Harris Hip (HHS) and HOOS scores; pre-operatively and at follow-up; the difference was defined as Δ. Patient characteristics, radiographic morphology and clinical outcome measures were compared between the 3 groups. Results: Patients that underwent a PAO were younger and more likely to be female. The PAO groups had a greater number of previous hip procedures (26%, 24%), most of which were hip arthroscopies. The patients that underwent hip arthroscopy had greater incidence of high alpha angles (66%) compared to the PAO groups (35%, 38%) (p<0.001). The PAO groups having slightly more dysplastic features (LCEA, AI, ACEA) (Table 1). At a mean follow-up of 2.5 years, there were no differences in the complication (7-10%, p=0.8) or re-operation rates (13%). Pre-operatively, the PAO groups had inferior HOOS and WOMAC scores compared to the arthroscopy group (p=0.02-7). No differences in the post-op scores were seen (Table 1). The groups that addressed the intra-articular pathology (arthroscopy and PAO-articular treatment) had significantly greater ΔHHS (23) compared to PAO-only (13) (p=0.02). Conclusion: Younger patients, those with a failed previous arthroscopy, without evidence of intra-articular wear and with worse pre-operative function were more likely to receive a PAO (with or without articular adjunct treatment). Addressing the intra-articular and impingement-related pathology (in addition to a when a PAO is considered necessary) was associated with better improvement in PROMs and should be strongly considered in the borderline hip. [Table: see text]

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357. A Comparison of Chest CT Findings in Cancer and Non-Cancer Patients with COVID-19

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab466.558 ◽

2021 ◽

Vol 8 (Supplement_1) ◽

pp. S282-S282

Author(s):

Alexandre Malek ◽

Hiba Dagher ◽

Ray Y Hachem ◽

Ying Jiang ◽

Anne-Marie Chaftari ◽

...

Keyword(s):

Mechanical Ventilation ◽

Hospital Admission ◽

Ct Scan ◽

Cancer Patients ◽

Clinical Outcomes ◽

Chest Ct ◽

Non Invasive ◽

Radiologic Findings ◽

Cancer Group ◽

Underlying Diseases

Abstract Background The purpose of this study was to compare chest computed tomography (CT) scan findings in cancer versus non-cancer patients with COVID-19 infection. We sought to assess the correlation between radiologic patterns of COVID-19 pneumonia, clinical course, and outcomes. Methods We performed a retrospective study of COVID-19 positive cancer and non-cancer pts who had chest CT scans at the time of diagnosis, at our hospital and 16 other centers in Asia, Australia, Europe, North America and South America, between March, 2020 and November, 2020. Patients’ age, underlying diseases, symptoms, laboratory studies, and radiologic findings consisting of bilateral ground-glass opacities (GGOs), multifocal organizing pneumonia (MOP) were collected in association with clinical outcomes. Results We identified 426 pts with cancer and 622 non-cancer pts. Thereafter, cancer pts were analyzed into 3 distinct groups and similar to non-cancer pts: GGOs group (n=224, 54%), GGOs+MOP group (n=61, 14.6%), and a third group of neither GGOs or MOP (n=131, 31.4%) in cancer pts, and in non-cancer pts: GGOs group (n=387, 62.8%), GGOs +MOP group (n=100, 16.2%), and a third group of neither GGOs or MOP (n=129, 21%). The median patients’ age was 54 in non-cancer pts vs 62 in cancer pts (p< 0.001) and there were more males in the non-cancer group 57% vs 47% (p=0.001). Cough was more prevalent in non-cancer pts, 71% vs 59% (p< 0.001) and similar to fever (73% vs 57%, p< 0.001). Neutropenia < 0.5 k/µL and lymphocytopenia < 1 k/µL were more frequent in cancer pts (p< 0.001). In cancer pts, there was no statistically significance difference between the 3 groups (hospital admission, mechanical ventilation, readmission within 30 days, and mortality), except pts who required non-invasive (NI) ventilation were more frequent in the GGOs group, 55% (p=0.005). In non-cancer, pts with GGOs +MOP have higher hospital admission, ICU transfer, NI- and mechanical ventilation compared to the 2 other groups (p< 0.001). While readmission to hospital or mortality rate within 30 days were similar between the 3 groups. Conclusion This study reveals that non-cancer pts tended to have more radiologic findings on chest CT scan compared to cancer pts at the time of COVID-19 diagnosis and were associated with more worrisome COVID-19-related clinical outcomes. Disclosures All Authors: No reported disclosures

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Clinical Outcomes of Revision Hip Arthroscopy for Synovial Chondromatosis

10.21203/rs.3.rs-151396/v1 ◽

2021 ◽

Author(s):

Guanying Gao ◽

Hongjie Huang ◽

Jianquan Wang ◽

Yingfang Ao ◽

Yan Xu

Keyword(s):

Clinical Outcomes ◽

Revision Surgery ◽

Hip Arthroscopy ◽

Synovial Chondromatosis ◽

Harris Hip Score ◽

Radiographic Evaluation ◽

Patient Reported ◽

Before And After ◽

Outcome Tool

Abstract Background: Synovial chondromatosis (SC) is a relatively rare disease and there were few studies on causes and clinical outcomes of revision surgery for SC. The purpose of this study was to evaluate clinical outcomes of revision hip arthroscopy for synovial chondromatosis.Methods: We evaluated consecutive patients who underwent revision hip arthroscopy for SC in our hospital between January 2008 and January 2020. Radiographic evaluation was made before and after surgery. Preoperative patient-reported outcomes (PROs) and PROs at final follow-up were obtained, including visual analog scale (VAS) for pain, the International Hip Outcome Tool-12 (iHOT-12) and modified Harris Hip Score (mHHS).Results: A total of 8 patients (mean age, 39.5 years; age range, 27-62 years; 5 males and 3 females) were included in this study. The recurrence rate of hip SC in our hospital was 6.8%. The average follow-up period after surgery was 47.3 months (range, 12–120 months). Before surgery, mean mHHS was 60.6±17.3 (range, 20-77), mean iHOT-12 was 43.8±13.7 (range, 18-69), and mean VAS was 3.1±1.7 (range, 1-7). At the final post-operative follow-up, mean mHHS was 83.8±16.6 (range, 43-91), iHOT-12 was 80.6±19.7 (range, 32-90), and mean VAS was 0.6±1.8 (range, 0-5). All results demonstrated statistically significant improvement (P < 0.05). Recurrence of SC was found in 2 patients 1 year and 4 years after revision hip arthroscopy, respectively.Conclusion: Hip arthroscopy had good clinical outcomes for revision surgery of SC.

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Predictors of Clinical Outcomes After Hip Arthroscopy: 5 Year Follow- Up Analysis of 1038 Patients

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120s00385 ◽

2020 ◽

Vol 8 (7_suppl6) ◽

pp. 2325967120S0038

Author(s):

Benjamin Domb ◽

Cammille Go ◽

David Maldonado ◽

Sarah Chen ◽

Ajay Lall

Keyword(s):

Body Mass Index ◽

Multivariate Analysis ◽

Clinical Outcomes ◽

Body Mass ◽

Predictive Factors ◽

Hip Arthroscopy ◽

Alpha Angle ◽

Joint Space ◽

Bivariate Analysis

Objectives: Identify predictive factors of midterm outcomes after hip arthroscopy in a cohort of 1038 patients, whose outcomes at minimum 2-year follow-up have previously been reported. In addition, to provide a comparison of short-term and midterm predictive factors in outcome measures following hip arthroscopy. Methods: Data were prospectively collected and retrospectively reviewed on all patients undergoing hip arthroscopy between February 2008 and June 2012. Patients were included if they had minimum 5-year follow-up on 3 patient reported outcomes: Nonarthritic Hip Score (NAHS), modified Harris Hip Score (mHHS), and Hip Outcome Score-Sport Specific Subscale (HOS-SSS). Patients were excluded if they had any prior ipsilateral hip conditions. Using bivariate and multivariate analyses, we analyzed the effect of 36 preoperative and intraoperative variables on NAHS. Results: A total of 1038 patients met our listed inclusion and exclusion criteria, with a mean follow-up time of 62.0 months (range, 60.0 - 120.0 months). The bivariate analysis identified 11 variables (4 categorical and 7 continuous) that were predictive of 5-year postoperative NAHS. For the multivariate analysis, 7 variables were identified as being significant: preoperative NAHS, body mass index (BMI), age, lateral joint space, alpha angle, revision hip arthroscopy, and acetabular microfracture. These 7 variables were also predictive in the bivariate analysis. Conclusion: This study reports favorable midterm clinical outcomes in the largest cohort of hip arthroscopies with minimum 5-year follow up in the literature to date. Seven variables were identified as being significant predictors in both the bivariate and multivariate analysis: preoperative NAHS, body mass index (BMI), age, lateral joint space, alpha angle, revision hip arthroscopy, and acetabular microfracture. Of these, preoperative NAHS, BMI, age, and revision hip arthroscopy were predictive of both 2-year and 5-year postoperative NAHS. These predictive factors may prove useful to clinicians in determining indications for hip arthroscopy and counseling patients on its expected outcomes.

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Primary hypophysitis: Experience of a Single Tertiary Center

Experimental and Clinical Endocrinology & Diabetes ◽

10.1055/a-0919-4388 ◽

2019 ◽

Vol 129 (01) ◽

pp. 14-21 ◽

Cited By ~ 1

Author(s):

Serdar Sahin ◽

Ozge Polat Korkmaz ◽

Hande Mefkure Ozkaya ◽

Tugce Apaydin ◽

Emine Sebnem Durmaz ◽

...

Keyword(s):

Adverse Effects ◽

Clinical Outcomes ◽

Treatment Modality ◽

Initial Treatment ◽

Steroid Treatment ◽

Treatment Modalities ◽

Bright Spot ◽

Radiologic Findings ◽

Appropriate Treatment ◽

Primary Hypophysitis

Abstract Purpose The authors review the clinical outcomes of patients with primary hypophysitis (PH). Methods Patients with PH who were followed up between 2007 and 2018 at our clinic were evaluated. Clinical, endocrinologic, pathologic, radiologic findings and treatment modalities were assessed. Results Seventeen patients with PH were assessed. The median follow-up was 24 (range, 6–84) months. Histologic confirmation was available in 8 patients (6 lymphocytic hypophysitis, 1 lymphocytic-granulomatous hypophysitis, 1 xanthomatous hypophysitis). None of the cases were diagnosed after pregnancy. Two patients had an autoimmune disease. The most commonly seen symptom was headache. The most common anterior pituitary deficiencies were hypocortisolemia and hypothyroidism. The radiologic findings of the patients at the time of diagnosis revealed various results including space-occupying lesion (41.2%), loss of posterior hypophysis bright spot (47.1%), pituitary stalk thickening (41.2%), uniform contrast enhancement (17.6%), partially empty sella (11.8%), optic chiasm compression (11.8%). The most frequent initial treatment modality was observation. Ten patients who were followed up conservatively had no endocrinologic deterioration; additional treatment was not needed in 8 of these 10 patients. The second most frequent initial treatment modality was pituitary surgery. Five patients received steroid treatment. We found serious adverse effects during steroid treatment in 3 of 5 (60%) patients; unilateral avascular necrosis of the femoral head (n=2), diabetes mellitus(n=1). Conclusion Correctly diagnosing PH and giving appropriate treatment is challenging. It is unclear whether active treatment with steroids improves clinical outcomes. The serious adverse effects of steroids are also taken into account. Observation, surgery and/or radiotherapy can be appropriate treatment modalities for selected patients.

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