Paper #12 - ISHA Annual Scientific Meeting 2016

Parafoveal Chondral Defects and Related Hip Lesions

Alberto Acerbi, MD, Lanzo D'intelvi ITALY
Andrea Fontana, MD, San Fedele Intelvi, Como ITALY

COF Lanzo Hospital, Lanzo d'Intelvi, Como, ITALY

FDA Status Not Applicable

Summary: An epidemiologic and topographic analysis of parafoveal chondral defects and related hip lesions in a large cohort of patients affected by isolated FAI.

Abstract:
Introduction
Parafoveal chondral lesions (PCLs) of the femoral head have been reported in advanced-stages of osteo-arthritis, as a manifestation of global joint degeneration. Occasionally, they have been associated to FAI as a single injury or in combination with others. Our purpose is to describe their epidemiological features in a large population affected by isolated FAI, arthroscopically treated. We also report the Odds of the most common lesions associated to PCLs.

Materials and Methods
We retrospectively reviewed a total number of 535 hips undergone hip arthroscopy.
Inclusion criteria for the study were: all data available; FAI as the only diagnosis; Tonnis X-ray evaluation score = 2; age from 20 to 50 yy; chondropathy area = 4cm2.
Two groups were defined: 33 hips (14%) with PCL and 202 hips (86%) of controls. An analysis of confounding factors such as age, sex and side of affected hip was conducted. The frequency, the topographical localization and the extent of both femoral and acetabular chondral defects were reported, as well as the presence of ligamentum Teres tears, central osteophytes, Pulvinar synovitis and Labrum lesions. The FAI morphotype was defined: PINCER , CAM and combined. A contingency table analysis was performed in order to evaluate the Odds of the presence of other hip lesions associated to PCLs.

Results
Groups were homogeneous for age, sex and side of affected hip. On the femoral head, chondral lesions apart from fovea were wider and deeper in the group with PCLs. Acetabular chondral lesions were mainly located on the posterosuperior area in both groups, with a significant higher concentration on the more central and deeper region for the PCLs cohort. Acetabular chondropathies were of higher grade and wider in the PCL group, while delamination was more significantly reported in the controls. The presence of ligamentum Teres tears and central osteophytes was significantly higher in the PCLs group, with an Odds Ratio value of respectively 4.42 (CI 95% 1.81-6.11) and 2.61 (CI 95% 1.05-6.51). FAI morphotype was not statistically significant for differences between groups.

Conclusions
PCLs are not rare conditions in isolated FAI affected hips. They are associated with inner and severe lesions of the central part of the acetabulum, involving both cartilage, bone and soft joint tissues. The FAI morphotype does not influence the development of PCL.