Evaluating Outcomes and Survivorship of Revision Arthroscopic Surgery for Femoroacetabular Impingement Compared With Matched Primary Cases
Notice bibliographique
Résumé
Background: The exponential rise in arthroscopy for femoroacetabular impingement (FAI) has led to increased revision surgery rates, although this is often an exclusion criterion from arthroscopy literature. Purpose: To examine the midterm (minimum 5-year follow-up) outcomes after revision arthroscopic correction of FAI compared with a matched control group of primary surgical cases. Study Design: Cohort study; Level of evidence, 3. Methods: Prospective outcome data, collected in a consecutive series of patients undergoing revision arthroscopic FAI correction, was retrospectively reviewed. Revision procedures were compared with a matched group of primary surgical cases. Survivorship was defined as the avoidance of total hip replacement (THR) and assessed using a Kaplan-Meier curve with the log-rank test. Regression analysis was conducted to identify predictors of THR conversion. Patient-reported outcomes (PROs) including modified Harris Hip Score (mHHS), University of California, Los Angeles (UCLA), 36-Item Short Form Health Survey (SF36), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) preoperatively and at 5 years postoperatively were compared between the groups. The proportion of patients across groups achieving the minimal clinically important difference (MCID) was compared for each PRO. Finally, a subgroup analysis was performed to compare the outcomes of those who had their index surgery at our clinic and those who had an index procedure elsewhere. Results: A total of 124 revision cases were compared with 268 primary cases. The most common indication for revision surgery was residual bony deformity. Both groups had high survivorship rates at 5 years (>90%) although revision cases did have a statistically higher conversion to THR than did primary cases (6.5% vs 1.5%; P = .008). Increasing age and revision surgery were identified in regression analysis as predictors for THR conversion. Where THR was avoided, improvements in PROs were observed in both groups ( P < .05 for all). Before surgery, revision cases reported lower scores for all PROs. At 5 years, the only statistical difference between the groups was in the distribution of mHHS scores. There were no differences in the rate of MCID achievement between groups. Conclusion: Residual bony deformity is the most common indication for revision arthroscopy. Revision procedures may have a lower survival than primary cases, although overall survivorship at midterm follow-up is high. Of the revision cases, 17% required further arthroscopy. Where THR is avoided, improvements in pain and function can be expected that are similar to primary surgical cases.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,005 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,002 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».