Six-Year Follow-Up Outcomes of Catheter Ablation of Para-Hisian Accessory Pathways

Background: Ablation of para-hisian accessory pathways (APs) remains challenging due to anatomic characteristics, and a few studies have focused on the causes for recurrence of radiofrequency ablation of para-hisian APs.Objective: This retrospective single center study aimed to explore the risk factors for recurrence of para-hisian APs.Methods: One hundred thirteen patients who had para-hisian AP with an acute success were enrolled in the study. In the 6-year follow-up, 15 cases had a recurrent para-hisian AP. Therefore, 98 patients were classified into the success group, while 15 patients were classified into the recurrence group. Demographic and ablation characteristics were analyzed.Results: Gender difference was similar in two groups. The median age was 36.2 years old and was younger in the recurrence group. Maximum ablation power was significantly higher in the success group (29 ± 7.5 vs. 22.9 ± 7.8, p < 0.01). Ablation time of final target sites was found to be markedly higher in the success group (123.4 ± 53.1 vs. 86.7 ± 58.3, p < 0.05). Ablation time <60 s was detected in 12 (12.2%) cases in the success group and 7 (46.7%) cases in the recurrence group (p < 0.01). Occurrence of junctional rhythm was significantly higher in the recurrence group (25.5% vs. 53.3%, p < 0.05). No severe conduction block, no pacemaker implantation, and no stroke were reported. Junctional rhythm during ablation (OR = 3.833, 95% CI 1.083–13.572, p = 0.037) and ablation time <60 s (OR = 5.487, 95% CI 1.411–21.340, p = 0.014) were independent risk factors for the recurrence of para-hisian AP.Conclusions: With careful and accurate mapping, it is relatively safe to ablate para-hisian AP. If possible, proper extension of ablation time could reduce the recurrence rate of para-hisian APs.

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11-year follow-up outcomes of catheter ablation of para-hisian accessory pathways

EP Europace ◽

10.1093/europace/euab116.055 ◽

2021 ◽

Vol 23 (Supplement_3) ◽

Author(s):

L Xu ◽

Q Chen ◽

T Zou ◽

K Cheng ◽

Y Ling ◽

...

Keyword(s):

Risk Factors ◽

Pacemaker Implantation ◽

Conduction Block ◽

Junctional Rhythm ◽

Ablation Time ◽

Accessory Pathways ◽

Funding Sources ◽

Success Group ◽

Recurrence Group

Abstract Funding Acknowledgements Type of funding sources: None. Background Ablation of para-hisian accessory pathways (APs) remains challenging due to anatomic characteristics and few studies have focused on the causes for recurrence of radiofrequency ablation of para-hisian APs. Objective This retrospective single center study was aimed to explore the risk factors for recurrence of para-hisian APs. Methods 113 patients who had a para-hisian AP with an acute success were enrolled in the study. In the 11-year follow-up, 15 cases had a recurrent para-hisian AP. Therefore 98 patients were classified into success group while 15 patients were classified into recurrence group. Demographic and ablation characteristics were analyzed. Results Gender difference was similar in two groups. The median age was 36.2 years old and was younger in recurrence group. Maximum ablation power was significantly higher in success group (29 ± 7.5 vs 22.9 ± 7.8, p < 0.01). Ablation time of final target sites was found to be markedly higher in success group (123.4 ± 53.1 vs 86.7 ± 58.3, p < 0.05). Ablation time less than 60 seconds was detected in 12 (12.2%) cases in success group and 7 (46.7%) cases in recurrence group (p < 0.01). Occurrence of junctional rhythm was significantly higher in recurrence group (25.5% vs 53.3%, p < 0.05). No severe conduction block, no pacemaker implantation and no stroke were reported. Junctional rhythm during ablation (OR = 3.833, 95%CI 1.083-13.572, p = 0.037) and ablation time <60s (OR = 5.487, 95%CI 1.411-21.340, p = 0.014) were independent risk factors for the recurrence of para-hisian AP. Conclusions Considering the long-term safety of ablation of para-hisian AP, proper extension of ablation time and increase of ablation power could be applied during operation.

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Prevention of Infections Associated With Permanent Cardiac Antiarrhythmic Devices by Implementation of a Comprehensive Infection Control Program

Infection Control and Hospital Epidemiology ◽

10.1086/502428 ◽

2004 ◽

Vol 25 (6) ◽

pp. 492-497 ◽

Cited By ~ 20

Author(s):

Abraham Borer ◽

Jacob Gilad ◽

Eytan Hyam ◽

Francisc Schlaeffer ◽

Pnina Schlaeffer ◽

...

Keyword(s):

Risk Factors ◽

Infection Control ◽

Medical Center ◽

Tertiary Care ◽

Pacemaker Implantation ◽

Relative Weight ◽

Control Program ◽

Cardiac Device ◽

Infection Control Program

AbstractObjective:To implement a comprehensive infection control (IC) program for prevention of cardiac device-associated infections (CDIs).Design:Prospective before-after trial with 2 years of follow-up.Setting:A tertiary-care, university-affiliated medical center.Patients:A consecutive sample of all adults undergoing cardiac device implantation between 1997 and 2002.Intervention:An IC program was implemented during late 2001 and included staff education, preoperative modification of patient risk factors, intraoperative control of strict aseptic technique, surgical scrubbing and attire, control of environmental risk factors, optimization of antibiotic prophylaxis, postoperative wound care, and active surveillance. The clinical endpoint was CDI rates.Results:Between 1997 and 2000, there were 7 CDIs among 725 procedures (mean annual CDI incidence, 1%). During the first 9 months of 2001, there were 7 CDIs among 167 procedures (4.2%; P = .007): CDIs increased from 7 among 576 to 3 among 124 following pacemaker implantation (P = .39) and from 0 among 149 to 4 among 43 following cardioverter-defibrillator implantation (P = .002). Of the 14 CDIs, 5 involved superficial wounds, 7 involved deep wounds, and 2 involved endocarditis. Following intervention, there were no cases of CDI among 316 procedures during 24 months of follow-up (4.2% reduction; P = .0005).Conclusions:We observed a high CDI rate associated with substantial morbidity. IC measures had an impact on CDI. Although the relative weight of each measure in the prevention of CDI remains unknown, our results suggest that implementation of a comprehensive IC program is feasible and efficacious in this setting.

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Risk factors concerning complications following permanent pacemaker implantation for patients on antithrombotic therapy: a cohort study

Journal of Investigative Medicine ◽

10.1136/jim-2019-001238 ◽

2020 ◽

Vol 68 (4) ◽

pp. 828-837

Author(s):

Mª Reyes Carrión-Camacho ◽

José Manuel Molina-Doñoro ◽

José Rafael González-López

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Anticoagulant Therapy ◽

Antithrombotic Therapy ◽

Associated Factors ◽

Pacemaker Implantation ◽

Permanent Pacemaker ◽

Single Center ◽

Factors Associated

The objective of this study was to identify the complications and associated factors presented by patients after pacemaker implantation, according to a regimen of antithrombotic therapy or without it. This is an analytical observational study on a prospective cohort of 310 consecutive patients with a permanent pacemaker implanted, included from January 1 to December 31, 2014 from 1 single center. The follow-up was conducted on 310 patients for 6 months. 239 patients (77%) received antithrombotic therapy at the time of the pacemaker implantation. 20.8% of complications are presented in patients without anticoagulant therapy, 80.8% of them being minor ones. In the case of patients with anticoagulant therapy, 30.3% of the complications are major ones. Factors associated with major complications were contusion (OR 2; 95% CI 1 to 3.8; p=0.049), and minor complications, arm immobilization >24 hours (p=<0.001) and contusion (p=0.002). This study found an increase in the overall risk and complications that can occur when implanting a permanent pacemaker in patients with antithrombotic therapy based on the time of immobilization and contusions after the implantation.

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P6557Permanent atrial fibrillation development in patients with DDD pacemaker -Rrisk factors and association with mortality in long-term

European Heart Journal ◽

10.1093/eurheartj/ehz746.1147 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

M Debski ◽

M Ulman ◽

A Zabek ◽

K Boczar ◽

K Haberka ◽

...

Keyword(s):

Risk Factors ◽

Atrial Fibrillation ◽

Hospital Discharge ◽

Pacemaker Implantation ◽

Cox Proportional Hazards Model ◽

Registration System ◽

All Cause Mortality ◽

Lost To Follow Up

Abstract Background In patients undergoing permanent DDD cardiac pacing, the maintenance of atrial contractility is important to ensure adequate ventricular filling and to guarantee an optimal ventricular ejection capacity. Atrial fibrillation (AF) is a major risk factor for thromboembolic events and is associated with increased cardiovascular and all-cause mortality. Purpose To analyse the risk factors for development of permanent AF in patients with DDD pacemaker and determine its association with all-cause mortality in long-term follow-up. Methods Retrospectively collected records comprised all consecutive patients who underwent primary DDD pacemaker implantation at single-centre between 1984–2014. Patients who were lost to follow-up after hospital discharge were excluded from analysis. Follow-up was completed on 31st August 2016. Definition of permanent AF was the occurence of AF which persisted until the end of follow-up. Data on patients' survival status and deceased patients' dates of death were collected from the national death registration system. Information of death date was available as of 31st August 2016. The endpoint was all-cause mortality. Results We included a total of 3771 patients and 24,432 patient-years of follow-up and exluded 157 (4%) patients who were lost to follow-up after hospital discharge. Mean follow-up was 78±62 months (max. 370 months), 1761 (47%) were female. Paroxysmal AF prior to DDD pacemaker implantation was detected in 1276 patients (34%). During entire follow-up 717 (19%) patients developed permanent AF in a mean period of 55±50 months. Analysis of risk factors for development of permanent AF is presented in Figure. Cox proportional hazards model with time-dependent covariate showed that development of permanent AF significantly increased mortality during follow-up (HR = 1.885, 95% CI, 1.654–2.148, P<0.001; with adjustment for age at implantation and sex: HR = 1.475, 95% CI, 1.294–1.682, P<0.001). Permanent AF risk factors Conclusions Female sex protected against permanent AF development, whereas age at implantation, history of paroxysmal AF and apical position of RV lead increased the risk. Permanent AF was significantly increasing the all-cause mortality, even after adjustment for age at implant and gender. Acknowledgement/Funding None

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Home-based Cardiac Rehabilitation in Covid Era: Is it a safe option?

European Journal of Preventive Cardiology ◽

10.1093/eurjpc/zwab061.350 ◽

2021 ◽

Vol 28 (Supplement_1) ◽

Author(s):

S Couto Pereira ◽

I Aguiar-Ricardo ◽

R Pinto ◽

N Cunha ◽

P Alves Da Silva ◽

...

Keyword(s):

Risk Factors ◽

Exercise Training ◽

Cardiac Rehabilitation ◽

Pacemaker Implantation ◽

Funding Sources ◽

Stent Restenosis ◽

Home Based ◽

Minor Adverse Event ◽

Online Assessments

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Home-based Cardiac Rehabilitation (CR-HB) models have been shown to be effective, however, there is a large variation of protocols and minimal evidence of effectiveness in higher risk populations, in which exercise at distance might be concerning. In addition, lack of reimbursement models has discouraged the widespread adoption of CR-HB. During the coronavirus 2019 (COVID-19) pandemic, an even greater gap in CR care has emerged due to the decreased availability of on-site services. Purpose Evaluation of the safety of a CR-HB program during COVID-19 pandemic. Methods Prospective cohort study which included patients (pts) who were participating in a centre-based CR program and accepted to participate in a CR-HB after the centre-based CR program closure due to COVID-19. The CR-HB consisted in a multidisciplinary digital CR program, including: 1.pts regular clinical and exercise risk assessment; 2.psychological tele-appointments and group sessions; 3. online exercise training sessions, which consisted of recorded videos and real time online exercise training sessions (each session recommended 3 times per week, during 60 minutes); 4.structured online educational program for pts and family members/caregivers, including educational videos and webinars; 5. follow-up fortnightly questionnaire to evaluate risk factors control and need for appointments or directing to hospital; 6. nutrition tele-appointments; 7. physician tele-appointments, scheduled according to follow-up questionnaire or at patients request (e-mail or telephone) to avoid unnecessary exposure and overload in the hospital. Minor and major adverse events such as hospitalizations due to cardiac event or other non CV reason, cardiac or noncardiac death, during or immediately after the exercise sessions, were collected. Results 116 cardiovascular disease (CVD) pts (62.6 ± 8.9 years, 95 males) who were attending a Centre-based CR program were included in a CR-HB program. Almost 90% (n = 103) of the participants had coronary artery disease; 13.8% pts had heart failure. The mean LVEF was 52 ± 11%; 31,1% of the population had at least moderate risk. Regarding risk factors, obesity was the most common risk factor (74.7%) followed by hypertension (59.6%), family history (41.8%), dyslipidaemia (37.9%), diabetes (18.1%), and smoking (12.9%). 98 CVD pts (85.5%) successfully completed all the online assessments. Three male participants dropped out for hospitalization due to knee surgery, pacemaker implantation and in-stent restenosis without relation to exercise sessions. No major events were registered during the exercise training sessions and only one minor adverse event, sprained ankle, was reported during the training sessions. Conclusions This CR-HB program, originated by the need of social distancing during COVID-19 pandemic, revealed to be a valuable and safe strategy to reach at distance most patients previously in a Centre-based CR program.

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RISK FACTORS FOR RE-RECURRENT CARPAL TUNNEL SYNDROME IN PATIENTS UNDERGOING LONG-TERM HEMODIALYSIS

Hand Surgery ◽

10.1142/s0218810413500123 ◽

2013 ◽

Vol 18 (01) ◽

pp. 63-68 ◽

Cited By ~ 2

Author(s):

Katsuhiko Kikuchi ◽

Koji Matsumoto ◽

Ken-Ichi Seo ◽

Yasumasa Ito ◽

Shinji Tomari

Keyword(s):

Risk Factors ◽

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Operative Procedure ◽

Trigger Finger ◽

Study Duration ◽

Tunnel Syndrome ◽

Recurrence Group

The purpose of this study was to evaluate risk factors for re-recurrent carpal tunnel syndrome (CTS) in long-term renal hemodialysis (HD) patients. Fifteen wrists of ten HD patients, follow-up period of minimum seven years after reoperation of CTS, were included in this study. Duration of HD, period from first operation to reoperation, shunt side was involved or not, presence of trigger finger and cervical destructive spondyloarthritis, and operative procedure performed during the reoperation (synovectomy was performed or not) were evaluated. Re-recurrent CTS was identified in four out of 15 wrists (27%). The period from first operation to reoperation, which was 3.8 years in the re-recurrence group and eight years in the no re-recurrence group, and the operative procedure had significant differences (synovectomy groups had no re-recurrence vs. no synovectomy groups had 82% re-recurrence). The results of this study suggested that synovectomy would be necessary for recurrent CTS in HD patients.

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Catheter ablation of difficult accessory pathways guided by three-dimensional electroanatomic mapping: first experience

EP Europace ◽

10.1093/europace/euab116.091 ◽

2021 ◽

Vol 23 (Supplement_3) ◽

Author(s):

N Vecchio ◽

A Bochoeyer ◽

JC Lopez Diez ◽

N Schnetzer ◽

J Dorado ◽

...

Keyword(s):

Catheter Ablation ◽

Success Rate ◽

Three Dimensional ◽

Electroanatomic Mapping ◽

Av Block ◽

Accessory Pathways ◽

Primary Success ◽

Acute Success ◽

One Year

Abstract Funding Acknowledgements Type of funding sources: None. Background Catheter ablation of paraseptal accessory pathways (PAP) is associated with longer fluoroscopy and procedure times, more radiofrequency lesions, as well as a higher rate of recurrence and complications. In anteroseptal or midseptal PAP, recurrence and risk of AV block is even higher. Guided ablations with a three-dimensional electroanatomic mapping system (3D) report greater efficacy and safety. Purpose To assess the acute success rate and complications of PAP 3D catheter ablation. Report the recurrence rate at one year of follow-up. Methods Descriptive analysis that included patients with difficult PAP 3D catheter ablation between 2017 and 2019. Acute success was defined as the disappearance of ventricular pre-excitation 15 seconds after starting the application and the absence of retrograde conduction (Figure). In all cases, a one-year follow-up was performed with ECG and 24-hour Holter. Results 25 patients were included during the mentioned period. The average age was 23 years, 60% (15 p) were men and 56% (14 p) were symptomatic due to palpitations. 1 patient had previous heart disease (ebstein"s anomaly). 36% (9 p) had a previous procedure: 5 patients with previous failed radiofrequency ablation, 1 patient with failed anteroseptal cryoablation and 3 patients with suspended ablation due to risk of AV block. The most frequent location was the posteroseptal. (Table) The primary success rate was 92% (23 of 25 p). Ablation was unsuccessful in two patients, one with Ebstein"s disease and the other with a left posteroseptal PAP. None of the patients presented complications associated with the procedure. During the one-year follow-up, one patient was registered with asymptomatic recurrence (1 of 23; 4.35%: right posteroseptal location), demonstrated by manifest preexcitation on the control ECG. Conclusion In our first experience, catheter ablation of difficult accessory pathways guided by three-dimensional electroanatomic mapping showed a high primary success rate without associated complications. Recurrence during follow-up was similar to that reported in the literature. Accessory Pathway locationPatientsRight Posteroseptal11 (44%)Left Posteroseptal5 (20%)Anteroseptal5 (20%)Midseptal4 (16%)Abstract Figure

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Risk Factors for Postoperative Recurrence of Ovarian Endometrioma in Young Women

10.21203/rs.3.rs-449055/v1 ◽

2021 ◽

Author(s):

Xing Xin ◽

Xiaochen Song ◽

Xinyang Zhao ◽

Shanshan WU ◽

Xinyao Hao ◽

...

Keyword(s):

Risk Factors ◽

Young Women ◽

Protective Factor ◽

Univariate Analysis ◽

Postoperative Recurrence ◽

Disease Stage ◽

Maximum Diameter ◽

Ovarian Endometrioma ◽

Recurrence Group

Abstract Background: Ovarian endometroma seriously affects women's health, and is susceptible to recurrence after surgery. However, only a few studies have been conducted to asses the risk factors for postoperative recurrence of ovarian endometrioma in young women, and no risk factors associated with recurrence have been found. The purpose of this study is to analyse the risk factors for postoperative recurrence of ovarian endometrioma in young women. Materials and Methods: We retrospectively analysed 196 young women who underwent ovarian endometrioma resection in Peking Union Medical College Hospital and Shengjing Hospital from January 2008 to January 2018 and were followed-up for at least 3 years postoperatively. The patients were divided into a recurrence group or a non-recurrence group. Their preoperative histories, laboratory indexes, intraoperative manifestations, and follow-up symptoms were analysed. Results: The cumulative recurrence rate of ovarian endometrioma in young women 3 and 5 years after surgery was 8.0%, and 20.3%, respectively. Univariate analysis showed significant differences in cancer antigen-125 levels (hazard ratio [HR]: 3.207, 95% confidence interval [CI]: 1.126–9.135, P = 0.029), the revised American Fertility Society (rAFS) disease stage (HR: 4.588, 95%CI: 1.422–14.805, P =0.011), postoperative pregnancy (HR: 0.28, 95%CI: 0.109–0.723, P = 0.008), and postoperative dysmenorrhoea (HR: 2.465, 95%CI :1.320–4.604, P = 0.005) between the two groups. Cox multivariate proportional risk analysis showed that rAFS disease stage (HR:3.783, 95%CI: 1.162–12.311, P=0.027) and postoperative dysmenorrhoea (HR: 2.291, 95%CI :1.222–4.296, P = 0.01) were risk factors for postoperative recurrence of ovarian endometrioma, whereas postoperative pregnancy (HR: 0.361, 95%CI: 0.138–0.944, P=0.038) was a protective factor for postoperative recurrence. There was no significant correlation between recurrence of ovarian endometrioma and age at surgery, age at the time of menarche, body mass index, duration of dysmenorrhoea, degree of dysmenorrhoea, genital malformation, surgical approach, maximum diameter of the cyst, and postoperative medication. Conclusion: rAFS disease stage and postoperative dysmenorrhoea are risk factors for the recurrence of ovarian endometrioma during long-term follow-up, whereas postoperative pregnancy is a protective factor.

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Cryoballoon ablation of the left atrial posterior wall reduces recurrence of persistent atrial fibrillation in patients with non-paroxysmal atrial fibrillation

10.22541/au.161408516.64943736/v1 ◽

2021 ◽

Author(s):

Takatoshi Shigeta ◽

Yasuteru Yamauchi ◽

Yuichiro Sagawa ◽

Atsuhito Oda ◽

Shinichi Tachibana ◽

...

Keyword(s):

Atrial Fibrillation ◽

Paroxysmal Atrial Fibrillation ◽

Left Atrial ◽

Conduction Block ◽

Persistent Atrial Fibrillation ◽

Posterior Wall ◽

Cryoballoon Ablation ◽

Acute Success ◽

Af Recurrence

Introduction: Detailed clinical outcomes of cryoballoon ablation of the left atrial (LA) posterior wall (LAPW) in patients with non-paroxysmal atrial fibrillation (AF) have not been fully examined. Methods: We analyzed the outcomes of 191 patients with non-paroxysmal AF, of whom 135 underwent cryoballoon ablation of the LAPW including the LA roof in addition to pulmonary vein isolation with a cryoballoon. Results: Complete conduction block at the LA roof was obtained in 97.0% (131/135) of patients and LAPW was isolated in 85.2% (115/135) of patients. Over 372 days (range, 182–450 days) of follow-up, atrial arrhythmia recurrence was observed in 55 (40.7%) patients, and atrial tachycardia (AT) recurrence accounted for 25.5% of cases. The prevalence of LA roof cryoballoon ablation tended to be higher in patients without recurrence than those with (74.3% vs. 61.8%, respectively; p=0.11), especially those with persistent AF recurrence (74.5% vs. 46.2%, p=0.01). Multivariate analysis revealed that cryoballoon ablation of the LA roof was a predictor of freedom from persistent AF recurrence and that it was not associated with AT recurrence. Durable LA roof lesions were confirmed in 18 (72.0%) of 25 patients who underwent redo ablation. Conclusion: Cryoballoon ablation of the LAPW leads to a sufficient acute success rate of complete conduction block and durable lesions of the LA roof without increasing the risk of AT recurrence. The prevalence of persistent AF recurrence decreases after additional cryoballoon ablation of the LAPW in patients with non-paroxysmal AF.

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Arthroscopic Capsular Plication in Patients With Labral Tears and Borderline Dysplasia of the Hip: Analysis of Risk Factors for Failure

The American Journal of Sports Medicine ◽

10.1177/0363546518808033 ◽

2018 ◽

Vol 46 (14) ◽

pp. 3446-3453 ◽

Cited By ~ 27

Author(s):

David R. Maldonado ◽

Itay Perets ◽

Brian H. Mu ◽

Victor Ortiz-Declet ◽

Austin W. Chen ◽

...

Keyword(s):

Risk Factors ◽

Patient Satisfaction ◽

Relative Risk ◽

Hip Arthroscopy ◽

Failure Group ◽

Capsular Plication ◽

Success Group ◽

Arthroscopic Capsular Plication ◽

Tönnis Grade

Background: Hip arthroscopy for the treatment of instability in the setting of borderline dysplasia is controversial. Capsular management in such cases is an important consideration, and plication has been described as a reliable technique, with good midterm outcomes reported when indications are appropriate. Hypothesis: Patients with borderline dysplasia who have a lower lateral center-edge angle (LCEA) and greater age will be at a higher risk of failure after arthroscopic capsular plication. Study Design: Case-control study; Level of evidence, 3. Methods: Data were retrospectively reviewed for all patients between 15 and 40 years of age who underwent hip arthroscopy from November 2008 to January 2015. Inclusion criteria were an LCEA between 18° and 25°, Tönnis grade ≤1, primary case with capsular plication, and minimum 2-year follow-up. Patients were excluded if they had any history of ipsilateral hip procedure or conditions such as Legg-Calve-Perthes disease, slipped capital femoral epiphysis, rheumatologic disease, and Tönnis grade ≥2. Age, sex, and body mass index data were retrieved for each patient. Patient-reported outcomes (PROs)—including modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score–Sports Specific Subscale, and a visual analog scale (VAS) for pain (0-10)—were obtained preoperatively and at a minimum of 2 years postoperatively, in addition to the postoperative International Hip Outcome Tool–12. The “success” group consisted of all patients who achieved the patient acceptable symptomatic state of mHHS ≥74 and had no ipsilateral hip surgery subsequent to their index arthroscopy. The “failure” group was composed of patients who were below the patient acceptable symptomatic state at latest follow-up or required secondary arthroscopy or conversion to total hip arthroplasty. Patient satisfaction and minimal clinically important difference were also calculated. Mean age for the failure group was applied as a cutoff age for subanalysis, and relative risk for failure was determined. Results: Ninety patients (97 hips; 79.5%) met criteria for the success group, and 25 patients (25 hips) met criteria for the failure group. No significant differences in preoperative baseline scores or VAS were found. However, there did appear to be a trend that the failure group had lower mean preoperative scores for all PRO measures and a higher VAS score. The differences in preoperative mHHS and NAHS closely approached significance ( P = .053). Postoperative PRO, VAS, and patient satisfaction scores of the success group were significantly higher than the failure group. The failure group was significantly older than the success group (28.5 ± 7.8 vs 23.5 ± 7.5 years, P = .005). Patients >35 years old were 2.25 times more likely to fail according to relative risk (95% CI, 1.10-4.60; P = .0266). LCEA did not differ between the groups, and no other risk factors for failure were identified. Conclusion: Stringent criteria for patient selection and meticulous repair or augmentation of the static stabilizers of the hip yielded favorable clinical outcomes in this study cohort with borderline dysplasia. Within this carefully selected group, the analysis revealed that increased age was the main risk factor for failure in the management of borderline hip dysplasia via isolated primary arthroscopic hip surgery with capsular plication.

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