Do Femoral Head Osteochondral Lesions Predict a Poor Outcome in Hip Arthroscopy Patients? A Matched Control Study With Minimum 5-Year Follow-Up
Authors: Ashberg L, Close MR, Perets I, Chaharbakhshi EO, Walsh JP, Mohr MR, Domb BG
Journal: Arthroscopy. 2019 Feb;35(2):419-431.
DOI: 10.1016/j.arthro.2018.08.053 | PMID: 30612766
Background
Femoral head (FH) osteochondral lesions are thought to impact hip arthroscopy outcomes, but their prognostic value remains unclear.
Methods
Matched cohort study of 96 hips with FH lesions vs. 96 controls, evaluating patient-reported outcomes (PROs) and pain scores over a minimum 5-year follow-up.
Key Findings
- Both groups had significant improvements in PROs and pain.
- Patients with FH lesions showed higher rates of conversion to total hip arthroplasty (32% vs. 16%).
- FH lesion group had more severe intra-articular pathology.
Conclusions
While FH lesions do not necessarily predict worse clinical improvements, they are associated with greater joint damage and increased risk of THA conversion.
What Does This Mean for Providers?
- FH osteochondral lesions should prompt careful preoperative counseling regarding the potential for advanced joint pathology and increased likelihood of future THA.
- Despite similar symptomatic improvements, close monitoring and realistic expectation management are critical in patients with these lesions.