Can Radiographic Joint Space Accurately Predict Chondral Damage During Hip Arthroscopy? A Cross-Sectional Analysis
Authors: Rosinsky PJ, Chen JW, Lall AC, Wojnowski NM, Shapira J, Maldonado DR, Domb BG
DOI: 10.1016/j.arthro.2020.01.034
Background
Radiographic joint space width is commonly used to assess hip joint health preoperatively, but its predictive value for intraoperative chondral damage is uncertain.
Methods
Analysis of 1,892 patients under 50 years undergoing hip arthroscopy compared radiographic joint space measurements with arthroscopic cartilage assessment.
Key Findings
- No reliable correlation was found between joint space narrowing and severity of cartilage damage.
- Slight narrowing of the lateral joint space may be modestly associated with acetabular cartilage damage, but overall joint space measurement is a poor predictor.
Conclusions
In patients with early arthritis (Tönnis grade 0-1), joint space narrowing may reflect anatomic variation rather than true cartilage damage.
What Does This Mean for Providers?
Relying solely on radiographic joint space to predict chondral damage during hip arthroscopy can be misleading. Clinical decision-making should incorporate comprehensive imaging and intraoperative assessment rather than joint space measurements alone. Providers should remain cautious interpreting narrow joint spaces as definitive evidence of cartilage pathology.