Excision of Labral Amorphous Calcification as a Part of Hip Arthroscopy-Clinical Outcomes in a Matched-Controlled Study
Purpose: To evaluate clinical outcomes, demographics, and radiographic findings for patients whose hip arthroscopies involved amorphous calcification (AC) excision and to compare them with a control group with no AC and with the general population regarding diabetes mellitus and hypothyroidism.
Methods: Patients who underwent primary hip arthroscopy involving surgical excision of AC deposit in the anterosuperior labralcapsular recess between October 2008 and July 2014 were reviewed. Demographics, radiographic findings, intraoperative findings, and procedures were reviewed. Minimum follow-up was 2 years and included visual analog scale for pain, patient satisfaction, and the following patient-reported outcome scores: modified Harris hip score, hip outcomes score sport-specific subscale, and nonarthritic hip score. These patients were matched (1:2 ratio) to patients who underwent hip arthroscopy with no AC using the following matching criteria: age at surgery ± 5 years, body mass index ± 5, gender, type of labral treatment, and type of capsular treatment.
Results: We reviewed 12 cases in 11 female patients. Mean latest follow-up scores improved from 64.0 to 83.4 (P = .003) for modified Harris hip score, from 57.6 to 80.6 (P < .001) for nonarthritic hip score, from 35.4 to 62.7 (P = .021) for hip outcomes score sport-specific subscale, and from 6.4 to 2.8 (P = .016) for visual analog scale. The survivorship rate was 91.7%, with one hip converting to total hip arthroplasty. Mean patient satisfaction was 8.4 ± 2.3. Six hips of the 12 (50%) had clock face localization of the AC. They were all between 11 and 12 with a mean of 12:30. Postoperative radiographic findings showed no subsequent AC in all 12 hips. No complications or revisions were reported. There were no significant differences between the AC group and the control group.
Conclusions: The treatment of AC as part of hip arthroscopy for labral tear and femoro-acetabular impingement is safe and has favorable and similar outcomes compared with a control group at minimum 2-year follow-up. Female gender may be a risk factor for the development of AC. There is no strong evidence that AC should be debrided.